CAJ | 학술논문

目的对在显微镜下手术的颅底脑膜瘤患者进行回顾、分析,以提高其效果及生活质量.方法按肿瘤生长部位不同,选择不同的手术入路.在切瘤过程中常规使用Zeis显微镜进行手术操作.部分未能全切者术后辅以γ-刀放射治疗.结果26例病例中全切除23例,大部分切除2例,部分切除1例.本组术后无死亡病例.神经功能及症状体征加重1例.3例原术前有癫痫发作患者经手术及术后行抗癫痫治疗后痊愈.余全部都有不同程度恢复、好转或痊愈.结论颅底脑膜瘤是血运异常丰富的实质性肿瘤,且颅底解剖复杂,凹凸不平,视野视角狭小多变,仍是专科的技术难点、热点之一.笔者认为:对血管异常丰富、风险较大者,术中使用高速磨钻扩大视野,骨窗要尽量贴近颅底,降低颅压及充分暴露肿瘤,使用显微操作技术,才能提高手术安全性及手术效果,减少并发症的发生,而显微技术是手术成功、安全的关键.
목적대재현미경하수술적로저뇌막류환자진행회고、분석,이제고기효과급생활질량.방법안종류생장부위불동,선택불동적수술입로.재절류과정중상규사용Zeis현미경진행수술조작.부분미능전절자술후보이γ-도방사치료.결과26례병례중전절제23례,대부분절제2례,부분절제1례.본조술후무사망병례.신경공능급증상체정가중1례.3례원술전유전간발작환자경수술급술후행항전간치료후전유.여전부도유불동정도회복、호전혹전유.결론로저뇌막류시혈운이상봉부적실질성종류,차로저해부복잡,요철불평,시야시각협소다변,잉시전과적기술난점、열점지일.필자인위:대혈관이상봉부、풍험교대자,술중사용고속마찬확대시야,골창요진량첩근로저,강저로압급충분폭로종류,사용현미조작기술,재능제고수술안전성급수술효과,감소병발증적발생,이현미기술시수술성공、안전적관건.
Objective Throuhg reviews and analysis of microsurgery in cranial base meningioma to improve the effect of surgery and the quality of life in patients.Methods Various surgical approaches were chosen according to the position of tumor.Zeis microscope was routinely used during the tumor resection.Embolization of vessels was taken in few patients before surgery.Some patients failed to total removal were assisted with gamma knife afterwards.Results Of the 26 patients,total resection of tumor were achieved in 23 cases,most resection in 2, partial in 1,no death case.One patient was with aggravated nerve functions,symptoms or signs.Three patients with seizure were al cured after treating with antiepileptic therapy during and post surgery.The rest of patients were in different degree of recovery,improvement or cure.Conclusion Cranial base meningioma is one kind of solid tumor with rich blood supply, and the skul base anatomy is complicated and vision field is limited and variable,thus it remains one of the technical difficulties and hotspots in neurosurgery field.In our opinion,to those patients with abundant vessels tumors,embolization of vessels should be taken before surgery.During the surgery,high speed dril wil help to widen the vision field,bone window should be low enough to close the skul base.And intracranial pressure should be decreased,tumor should be exposed adequately.Microsurgery technique can improve the safety and effect of surgery,reduce complications,which plays the key role in the success and safety of surgery.