CAJ | 학술논문

【目的】总结切除岩斜区脑膜瘤显微手术经验和技巧。【方法】回顾分析本院1991年1月至2012年12月收治和手术证实岩斜区脑膜瘤90例患者的临床资料，中上斜坡向幕上发展者采用经幕上下联合入路35例，中下斜坡向幕下发展者采用幕下经乙状窦入路50例，上斜坡向岩尖及海绵窦发展者采用颞下小脑幕岩骨入路5例。【结果】90例93次手术，其中术后再出血第二次手术3例，肿瘤镜下全切除72例（80．0％），次全切除11例（12．2％），大部分切除7例（7．8％）。临床痊愈恢复正常工作70例，生活需要照顾18例，死亡2例。【结论】选择正确的手术入路，精巧的显微手术技巧，加强术后观察和积极处理并发症有助于提高岩斜区脑膜瘤的全切除，减少死亡和病残率。
【목적】총결절제암사구뇌막류현미수술경험화기교。【방법】회고분석본원1991년1월지2012년12월수치화수술증실암사구뇌막류90례환자적림상자료，중상사파향막상발전자채용경막상하연합입로35례，중하사파향막하발전자채용막하경을상두입로50례，상사파향암첨급해면두발전자채용섭하소뇌막암골입로5례。【결과】90례93차수술，기중술후재출혈제이차수술3례，종류경하전절제72례（80．0％），차전절제11례（12．2％），대부분절제7례（7．8％）。림상전유회복정상공작70례，생활수요조고18례，사망2례。【결론】선택정학적수술입로，정교적현미수술기교，가강술후관찰화적겁처리병발증유조우제고암사구뇌막류적전절제，감소사망화병잔솔。
Objective To summarize clinical experiences and microsurgical technique for the excision of petroclival meningiomas .[Methods]Clinical data of 90 patients with petroclival meningioma confirmed by sur-gery in our hospital from Jan .1991 to Dec .2012 was analyzed retrospectively .Of these patients ,35 patients with meningioma extending to supratentorium from mid-superior clivus underwent the surgery through the combined supratentorial-infratentorial approach ,and 50 patients with meningioma extending to infratentorium from mid-inferior clivus underwent the surgery through infratentorial sigmoid sinus approach .Five patients with meningioma extending to petrous apex and cavernous sinus underwent the surgery through subtemporal transpetrosal-transtentorial approach .[Results] Of 93 patients(93 operations) ,3 patients underwent re-oper-ation due to postoperative hemorrhage .Endoscopic total resection of the tumor was achieved in 72 patients (80% ) ,and subtotal resection was achieved in 11 patients(12% ) ,and partial resection was achieved in 8 pa-tients(8% ) .The 70 patients got clinical cure and recovered their normal life ,and 18 patients needed the care in life ,and 2 patients died .[Conclusion]Correct operation approach ,skillful microsurgical technique ,inten-sive postoperative observation and active treatment of complications are helpful to improve total resection rate of petroclival meningioma and decrease mortality and disability rate .