中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2010年
1期
61-63
,共3页
脑膜瘤%岩斜区%显微外科手术%治疗
腦膜瘤%巖斜區%顯微外科手術%治療
뇌막류%암사구%현미외과수술%치료
Meningioma%Petroclival%Microsurgery%Therapy
目的 探讨岩斜区脑膜瘤显微手术的治疗效果. 方法 对21例行显微手术治疗的岩斜脑膜瘤患者(采用枕下乙状窦后入路3例,幕上下经岩骨乙状窦前入路18例)的临床资料及手术效果进行分析. 结果 肿瘤获全切(Simpson I、Ⅱ)11例,次全切(Simpson Ⅲ)5例,大部分切除4例,部分切除1例.术后死亡1例.术后早期出现动眼神经瘫5例,面神经功能障碍4例,后组神经瘫2例,对侧肢体轻瘫2例.术后随访3个月～4年,3例不完全动眼神经瘫1个月后恢复,2例完全损伤未恢复:4例面神经功能障碍中3例3个月后恢复,1例未恢复;2例后组神经瘫术后1周全恢复;2例对侧肢体功能障碍,术后1个月恢复.5例患者术后行γ刀治疗.没有病例出现术后复发. 结论 岩斜区脑膜瘤手术入路的选择是关键,乙状寞前人路是目前最有效的手术入路.
目的 探討巖斜區腦膜瘤顯微手術的治療效果. 方法 對21例行顯微手術治療的巖斜腦膜瘤患者(採用枕下乙狀竇後入路3例,幕上下經巖骨乙狀竇前入路18例)的臨床資料及手術效果進行分析. 結果 腫瘤穫全切(Simpson I、Ⅱ)11例,次全切(Simpson Ⅲ)5例,大部分切除4例,部分切除1例.術後死亡1例.術後早期齣現動眼神經癱5例,麵神經功能障礙4例,後組神經癱2例,對側肢體輕癱2例.術後隨訪3箇月～4年,3例不完全動眼神經癱1箇月後恢複,2例完全損傷未恢複:4例麵神經功能障礙中3例3箇月後恢複,1例未恢複;2例後組神經癱術後1週全恢複;2例對側肢體功能障礙,術後1箇月恢複.5例患者術後行γ刀治療.沒有病例齣現術後複髮. 結論 巖斜區腦膜瘤手術入路的選擇是關鍵,乙狀寞前人路是目前最有效的手術入路.
목적 탐토암사구뇌막류현미수술적치료효과. 방법 대21례행현미수술치료적암사뇌막류환자(채용침하을상두후입로3례,막상하경암골을상두전입로18례)적림상자료급수술효과진행분석. 결과 종류획전절(Simpson I、Ⅱ)11례,차전절(Simpson Ⅲ)5례,대부분절제4례,부분절제1례.술후사망1례.술후조기출현동안신경탄5례,면신경공능장애4례,후조신경탄2례,대측지체경탄2례.술후수방3개월～4년,3례불완전동안신경탄1개월후회복,2례완전손상미회복:4례면신경공능장애중3례3개월후회복,1례미회복;2례후조신경탄술후1주전회복;2례대측지체공능장애,술후1개월회복.5례환자술후행γ도치료.몰유병례출현술후복발. 결론 암사구뇌막류수술입로적선택시관건,을상막전인로시목전최유효적수술입로.
Objective To explore the efficacy of microsurgery on petroclival meningiomas.Methods A retrospective analysis of the clinical data and the prognosis of microsurgery was performed on 21 patients with petroclival meningioma.Suboccipital retrosigmoid approach was adopted in 3 and supra-or infra-tentorial transpetrosal presigmoid approach was adopted in 18.The clinical manifestations and surgical outcomes were analyzed to evaluate the significance of microsurgery. Results Of the 21 patients with petroclival meningioma,total resection(Simpson I,Ⅱ)and sub-total resection(Simpson Ⅲ)were achieved in 11 and 5,respectively;resection of major part was obtained in 4 and partial resection was obtained in 1 with 1 postoperative death.At the early stage of postoperation,5 patients developed oculomotor palsy and 4 developed dysfunction of facial nerve;2 were found caudal cranial nerve palsy and 2 were found hemiplegia contralateral to the tumor.All these patients were followed up for about 3 months to 4 years:3 recovered from the oculomotor palsy 1 month after the operation and 3 recovered from the dysfunction of facial nerve 3 months after the operation;2 recovered from caudal cranial nerve palsy 1 week after the operation and 2 recovered from hemiplegia 1 month after the operation.5 were performed γ knife radiotherapy without tuinor recurrence. Conclusion Choosing the fight approach is the key to petroclival meningiomas management and presigmoid approach is the most effective way at present.
