中华显微外科杂志
中華顯微外科雜誌
중화현미외과잡지
Chinese Journal of Microsurgery
2013年
5期
431-435
,共5页
刘党奇%黄权%叶小帆%石忠松%王海军
劉黨奇%黃權%葉小帆%石忠鬆%王海軍
류당기%황권%협소범%석충송%왕해군
鞍区%脑膜瘤%视力%视神经管减压%显微神经外科
鞍區%腦膜瘤%視力%視神經管減壓%顯微神經外科
안구%뇌막류%시력%시신경관감압%현미신경외과
Tuberculum region%Meningioma%Vision%Optical canal decompression%Microneurosurgery
目的 探讨鞍区脑膜源性肿瘤根治性切除和视神经管减压对于鞍区脑膜源性肿瘤患者术后视力的影响. 方法 收集2010年1月至2012年10月手术治疗的鞍区脑膜源性肿瘤中的脑膜瘤和血管外皮瘤切除术44例患者的临床资料,回顾性分析肿瘤切除程度的Simpson分级、肿瘤粘连程度、视神经管减压和患者临床预后及视力转归的关系,并结合文献进行对比分析. 结果 44例患者中Simpson Ⅰ级切除31例,术中显示有明显肿瘤和重要结构粘连者9例,磨开视神经管17例,术后追踪视力好转者17例,视力维持不变者11例,视力恶化者3例.SimpsonⅡ级切除8例和SimpsonⅢ级切除5例,共13例中,术中显示存在明显瘤体粘连者10例,磨开视神经管3例,术后追踪视力好转8例,视力维持不变4例,视力恶化1例.肿瘤切除程度Simpson Ⅰ级与Ⅱ级和Ⅲ级之间的术后视力差异无统计学意义(P＞0.05)；肿瘤粘连降低肿瘤全切除率的差异有统计学意义(P＜0.05).磨开视神经管患者的术后视力优于未磨开者(P＜0.05). 结论 鞍区脑膜源性肿瘤与重要结构的粘连影响肿瘤的切除程度,有条件的肿瘤根治性切除没有影响术后视力,磨开视神经管在一定程度上可以改善术后的视力.
目的 探討鞍區腦膜源性腫瘤根治性切除和視神經管減壓對于鞍區腦膜源性腫瘤患者術後視力的影響. 方法 收集2010年1月至2012年10月手術治療的鞍區腦膜源性腫瘤中的腦膜瘤和血管外皮瘤切除術44例患者的臨床資料,迴顧性分析腫瘤切除程度的Simpson分級、腫瘤粘連程度、視神經管減壓和患者臨床預後及視力轉歸的關繫,併結閤文獻進行對比分析. 結果 44例患者中Simpson Ⅰ級切除31例,術中顯示有明顯腫瘤和重要結構粘連者9例,磨開視神經管17例,術後追蹤視力好轉者17例,視力維持不變者11例,視力噁化者3例.SimpsonⅡ級切除8例和SimpsonⅢ級切除5例,共13例中,術中顯示存在明顯瘤體粘連者10例,磨開視神經管3例,術後追蹤視力好轉8例,視力維持不變4例,視力噁化1例.腫瘤切除程度Simpson Ⅰ級與Ⅱ級和Ⅲ級之間的術後視力差異無統計學意義(P＞0.05)；腫瘤粘連降低腫瘤全切除率的差異有統計學意義(P＜0.05).磨開視神經管患者的術後視力優于未磨開者(P＜0.05). 結論 鞍區腦膜源性腫瘤與重要結構的粘連影響腫瘤的切除程度,有條件的腫瘤根治性切除沒有影響術後視力,磨開視神經管在一定程度上可以改善術後的視力.
목적 탐토안구뇌막원성종류근치성절제화시신경관감압대우안구뇌막원성종류환자술후시력적영향. 방법 수집2010년1월지2012년10월수술치료적안구뇌막원성종류중적뇌막류화혈관외피류절제술44례환자적림상자료,회고성분석종류절제정도적Simpson분급、종류점련정도、시신경관감압화환자림상예후급시력전귀적관계,병결합문헌진행대비분석. 결과 44례환자중Simpson Ⅰ급절제31례,술중현시유명현종류화중요결구점련자9례,마개시신경관17례,술후추종시력호전자17례,시력유지불변자11례,시력악화자3례.SimpsonⅡ급절제8례화SimpsonⅢ급절제5례,공13례중,술중현시존재명현류체점련자10례,마개시신경관3례,술후추종시력호전8례,시력유지불변4례,시력악화1례.종류절제정도Simpson Ⅰ급여Ⅱ급화Ⅲ급지간적술후시력차이무통계학의의(P＞0.05)；종류점련강저종류전절제솔적차이유통계학의의(P＜0.05).마개시신경관환자적술후시력우우미마개자(P＜0.05). 결론 안구뇌막원성종류여중요결구적점련영향종류적절제정도,유조건적종류근치성절제몰유영향술후시력,마개시신경관재일정정도상가이개선술후적시력.
Objective To investigate the influence of the radical resection and the optic canal unroofing on the postoperative vision in the patients with tuberculm region meningeal tumors.Matheods A retrospective analysis was made in 44 patients with tuberculm region meningeal tumors,from January 2010 to October 2012.The clinical data including the Simpson grades,adhesion between tumor and the surrounding structures,optic canal decompression,and postoperative vision were studied,and followed-up.Results In all 44 cases,there were 31 patients with Simpson grade Ⅰ resection,their postoperative vision of 17 patients were improved,eleven unchanged,and 3 worse.Out of them,tumors showed more adhesive in 9 cases,unroofed the optic canal in 17 cases.There were 13 cases in the other group including 8 cases with Simpson grade Ⅱ and 5 cases with Simpson grade Ⅲ,their postoperative vision of 8 patients were improved,four unchanged,and 1 worse.Out of them,tumors showed more adhesive to the surroundings in 10 cases,unroofed the optic canal in 3 cases.There were no different postoperative vision among the Simpson grades by the Chi-Square test (P ＞ 0.05).The less adhesive of the meningeal tumors,the better resection grade would be (P ＜ 0.05).And unroofed the optic canal group showed better postoperative vision than the not unroofed ones (P ＜ 0.05).Conclusion In the tuberculum region meningeal tumors,the Simpson resection grade was related to adhesion between the meningeal tumors and the surroundings,not to postoperative vision.The optic canal decompression can improve their visual outcome in some cases.
