CAJ | 학술논문

目的：探讨高龄患者中央区巨大脑膜瘤的病史特点、治疗方法、手术决策、围手术期处理及疗效。方法回顾性分析70岁以上运动功能区脑膜瘤45例患者的临床表现和病史特点，分析治疗方法的选择、手术决策、围手术期及术后处理与疗效的关系。结果切除范围根据改良Simpson分级，Ⅰ级切除者32例，Ⅱ级切除者13例。术后患者全部存活，出现肺部感染5例，心律不齐6例，消化道出血2例，继发性脑梗塞3例，迟发性颅内血肿2例。术后随访3月～3年，均未见复发，运动功能较术前均有明显改善，恢复正常行走能力，有5例出现记忆力下降。结论高龄患者中央区巨大脑膜瘤与矢状窦、中央沟静脉、外侧裂血管及重要神经结构关系紧密，采用显微神经外科技术，中央区巨大脑膜瘤的高龄患者可取得不错的疗效，但术后易出现各种并发症。
목적：탐토고령환자중앙구거대뇌막류적병사특점、치료방법、수술결책、위수술기처리급료효。방법회고성분석70세이상운동공능구뇌막류45례환자적림상표현화병사특점，분석치료방법적선택、수술결책、위수술기급술후처리여료효적관계。결과절제범위근거개량Simpson분급，Ⅰ급절제자32례，Ⅱ급절제자13례。술후환자전부존활，출현폐부감염5례，심률불제6례，소화도출혈2례，계발성뇌경새3례，지발성로내혈종2례。술후수방3월～3년，균미견복발，운동공능교술전균유명현개선，회복정상행주능력，유5례출현기억력하강。결론고령환자중앙구거대뇌막류여시상두、중앙구정맥、외측렬혈관급중요신경결구관계긴밀，채용현미신경외과기술，중앙구거대뇌막류적고령환자가취득불착적료효，단술후역출현각충병발증。
Objective To discuss the diagnosis ,the microsurgery ,the perioperative management and the effect of the big size meningeoma in brain central area .Methods The clinical data of 45 patients over 70 years old with large meningeoma in central area were analyzed retrospectively . Results Simpson grade Ⅰresection were achieved in 32 patients ,grade Ⅱin 13 .At postoperative pulmonary infection in 5 cases,arrhythmia in 6,hemorrhage of digestive tract in 2,secondary cerebral infarction in 3 and intracranial hematoma in 2.Memory decline in 5 cases.No hemiparalysis happend and no patient died .All patients were followed up for 3 months to 3 years without recurrence .Conclusions Central area giant meningioma in elderly patients have close relation with sagittal sinus , central sulcus , lateral fissure vascular and neural structure .The neurosurgerical operation with microscopic technique for giant meningiomas in central area in elderly patients can get good curative effect , but postoperative complications are easy to happen .