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
436-439
,共4页
许新科%李军亮%张善义%翁胤仑%欧阳乐平%李方成
許新科%李軍亮%張善義%翁胤崙%歐暘樂平%李方成
허신과%리군량%장선의%옹윤륜%구양악평%리방성
脑膜瘤%鞍结节%显微外科手术
腦膜瘤%鞍結節%顯微外科手術
뇌막류%안결절%현미외과수술
Meningiomas%Tuberculum sellae%Microsurgical operation
目的 探讨鞍结节脑膜瘤的显微外科治疗策略. 方法 对2005年1月至2013年7月应用显微外科手术治疗的鞍结节脑膜瘤35例进行回顾性分析,通过分析其手术入路、手术切除程度、手术效果及并发症等,总结鞍结节脑膜瘤显微外科治疗经验. 结果 所有患者均接受显微外科治疗,单侧额下入路20例,纵裂入路4例,翼点或扩大翼点入路10例,翼点及额下联合入路1例.肿瘤切除程度按Simpson分级评估,Ⅱ级26例,Ⅲ级4例,Ⅳ级5例,肿瘤全切除率达85.7％.术前合并不同程度视力视野障碍的28例,术后视力较术前好转20例,无明显变化5例,恶化3例.视力改善率71.4％.无死亡病例. 结论 鞍结节脑膜瘤周围毗邻结构重要,显微外科手术是其治疗的主要方法.应根据肿瘤大小、生长方式、视力受损程度及术者习惯等选择不同的手术入路.熟悉的显微解剖知识,娴熟的显微外科技巧是手术成功的关键.
目的 探討鞍結節腦膜瘤的顯微外科治療策略. 方法 對2005年1月至2013年7月應用顯微外科手術治療的鞍結節腦膜瘤35例進行迴顧性分析,通過分析其手術入路、手術切除程度、手術效果及併髮癥等,總結鞍結節腦膜瘤顯微外科治療經驗. 結果 所有患者均接受顯微外科治療,單側額下入路20例,縱裂入路4例,翼點或擴大翼點入路10例,翼點及額下聯閤入路1例.腫瘤切除程度按Simpson分級評估,Ⅱ級26例,Ⅲ級4例,Ⅳ級5例,腫瘤全切除率達85.7％.術前閤併不同程度視力視野障礙的28例,術後視力較術前好轉20例,無明顯變化5例,噁化3例.視力改善率71.4％.無死亡病例. 結論 鞍結節腦膜瘤週圍毗鄰結構重要,顯微外科手術是其治療的主要方法.應根據腫瘤大小、生長方式、視力受損程度及術者習慣等選擇不同的手術入路.熟悉的顯微解剖知識,嫻熟的顯微外科技巧是手術成功的關鍵.
목적 탐토안결절뇌막류적현미외과치료책략. 방법 대2005년1월지2013년7월응용현미외과수술치료적안결절뇌막류35례진행회고성분석,통과분석기수술입로、수술절제정도、수술효과급병발증등,총결안결절뇌막류현미외과치료경험. 결과 소유환자균접수현미외과치료,단측액하입로20례,종렬입로4례,익점혹확대익점입로10례,익점급액하연합입로1례.종류절제정도안Simpson분급평고,Ⅱ급26례,Ⅲ급4례,Ⅳ급5례,종류전절제솔체85.7％.술전합병불동정도시력시야장애적28례,술후시력교술전호전20례,무명현변화5례,악화3례.시력개선솔71.4％.무사망병례. 결론 안결절뇌막류주위비린결구중요,현미외과수술시기치료적주요방법.응근거종류대소、생장방식、시력수손정도급술자습관등선택불동적수술입로.숙실적현미해부지식,한숙적현미외과기교시수술성공적관건.
Objective To explore microsurgical treatment of tuberculum sellae meningiomas.Methods A retrospective analysis was made on 35 cases of tuberculum sellae meningiomas operated from January 2005 to July 2013 in neurosurgery department of Sun Yat-sen Memorial Hospital,surgical approach,removal rate,surgical effect and complications were analysed.Results All patients were accepted microsurgical treatment,twenty cases were operated via subfrontal approach,four cases via anterior interhemispheric approach,ten cases via pterional approach,one case via combined subfrontal and pterional approach.According to Simpson grade,grade Ⅱ,rection was achieved in 26 cases,grade Ⅲ in 4 cases and grade Ⅳ in 5 cases.The total rection rate was 85.7％.There were 28 cases with merger ision loss and visual field defects preoperate,twenty cases were improved after operation,five cases with no change,three cases aggravated.The visual improved rate was achieved 71.4％,there was no surgical mortality case.Conclusion The surround tissue of tuberculum sellae meningiomas is very import ant,microsurgical rection is the main treatment.The choice of surgical approach should according to tumor size,growth pattern,degree of impaired vision and surgeon experience.Family with microanatomy and skillfull microsurgical techique can make sure operation succes.
