中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2014年
9期
692-694
,共3页
原发性硬膜外脑膜瘤%异位脑膜瘤%颅骨内脑膜瘤%临床特点%治疗
原髮性硬膜外腦膜瘤%異位腦膜瘤%顱骨內腦膜瘤%臨床特點%治療
원발성경막외뇌막류%이위뇌막류%로골내뇌막류%림상특점%치료
Primary extradural meningioma%Ectopic meningioma%Intraosseous meningioma%Clinical characteristics%Treatment
目的 研究头部原发性硬膜外脑膜瘤(PEM)的临床特点、治疗效果及预后情况.方法 针对山东大学齐鲁医院1994年5月至2012年12月收治19例头部PEM的年龄、性别、症状学、肿瘤位置、分型、影像学特点、手术结果、病理结果及随访资料进行了回顾性分析.结果 本组头部PEM占全部脑膜瘤的1.2%,男女比例1:0.7,平均年龄36.6岁,有两个高发年龄段;鼻塞及病变区无痛性逐渐生长的包块是常见的症状,平均病程3.07年;颅穹窿、副鼻窦腔、眶内与硬膜外腔是常见的发病部位;Ⅱ型最常见;肿瘤全切率100%,无围手术期死亡;良性与非典型性脑膜瘤分别占94.7%和6.3%;常见的组织亚型是上皮型和砂粒型.经0.25~8.5 年(平均2.43年)随访,复发1例,无死亡.结论 与原发性硬膜内脑膜瘤相比,头部PEM具有明显的临床特点;全部切除肿瘤及受累结构并组织缺损重建是最佳手术治疗方案;绝大多数肿瘤在全切除后预后良好.
目的 研究頭部原髮性硬膜外腦膜瘤(PEM)的臨床特點、治療效果及預後情況.方法 針對山東大學齊魯醫院1994年5月至2012年12月收治19例頭部PEM的年齡、性彆、癥狀學、腫瘤位置、分型、影像學特點、手術結果、病理結果及隨訪資料進行瞭迴顧性分析.結果 本組頭部PEM佔全部腦膜瘤的1.2%,男女比例1:0.7,平均年齡36.6歲,有兩箇高髮年齡段;鼻塞及病變區無痛性逐漸生長的包塊是常見的癥狀,平均病程3.07年;顱穹窿、副鼻竇腔、眶內與硬膜外腔是常見的髮病部位;Ⅱ型最常見;腫瘤全切率100%,無圍手術期死亡;良性與非典型性腦膜瘤分彆佔94.7%和6.3%;常見的組織亞型是上皮型和砂粒型.經0.25~8.5 年(平均2.43年)隨訪,複髮1例,無死亡.結論 與原髮性硬膜內腦膜瘤相比,頭部PEM具有明顯的臨床特點;全部切除腫瘤及受纍結構併組織缺損重建是最佳手術治療方案;絕大多數腫瘤在全切除後預後良好.
목적 연구두부원발성경막외뇌막류(PEM)적림상특점、치료효과급예후정황.방법 침대산동대학제로의원1994년5월지2012년12월수치19례두부PEM적년령、성별、증상학、종류위치、분형、영상학특점、수술결과、병리결과급수방자료진행료회고성분석.결과 본조두부PEM점전부뇌막류적1.2%,남녀비례1:0.7,평균년령36.6세,유량개고발년령단;비새급병변구무통성축점생장적포괴시상견적증상,평균병정3.07년;로궁륭、부비두강、광내여경막외강시상견적발병부위;Ⅱ형최상견;종류전절솔100%,무위수술기사망;량성여비전형성뇌막류분별점94.7%화6.3%;상견적조직아형시상피형화사립형.경0.25~8.5 년(평균2.43년)수방,복발1례,무사망.결론 여원발성경막내뇌막류상비,두부PEM구유명현적림상특점;전부절제종류급수루결구병조직결손중건시최가수술치료방안;절대다수종류재전절제후예후량호.
Objective To explore the clinical characteristics, efficacy and prognosis of primary extradural meningiomas (PEMs) in head. Methods A total of 19 treated surgically case of PEMs at Qilu Hospital, Shandong University between May 1994 and December 2012 were analyzed retrospectively with respects to their demographic features, presenting symptoms & duration, tumor location & type, imaging features, surgical results, pathological grade, histological subtype and follow-up outcomes. Results PEMs in head accounted for 1.2% of all meningiomas in this group. The male-to-female ratio was 1∶ 0.7. The mean age was 36.6 years with a bimodal distribution of age. The common presenting symptoms included nasal obstruction and a painless and gradually expanding mass in the region of lesion. The average duration of symptom was 3.07 years. The skull convexities, paranasal sinuse and nasal cavity, orbit and epidural space were common tumor sites. The most common type was typeⅡ. The rate of total tumor removal was 100%. And no perioperative mortality occurred in this series. Benign and atypical meningiomas accounted for 94.7% and 6.3% respectively. Meningothelial and psammomatous meningiomas were common histopathological subtypes. There was one case of tumoral recurrence. And no mortality was reported during a mean follow-up period of 2.43 (0.25-8.5) years. Conclusion PEMs in head have some marked clinical characteristics compared with primary intradural meningiomas. Total tumor removal together with a wide excision of all involved tissue followed by the reconstruction of tissue defects is the best surgical option. The prognosis is excellent in most cases after complete resection.
