CAJ | 학술논문

目的：探讨上矢状窦中后1/3脑膜瘤术中保护回流静脉的方法及意义，为确保手术成功提供参考依据。方法回顾性分析本院神经外科2011年8月至2013年8月收治的50例上矢状窦旁中后1/3脑膜瘤患者的临床资料，按照是否保护回流静脉分为观察组（36例）和对照组（14例）。观察组患者行静脉磁共振血管成像（MRV）检查，明确上矢状窦通畅程度与脑膜瘤周边静脉回流代偿情况，术中尽量保护回流静脉及正常脑组织，妥善处理受累矢状窦。对照组患者采用传统手术方式治疗，未评价矢状窦通畅情况，未保护回流静脉。依据Simpson标准评价肿瘤切除程度，比较两组患者肿瘤全切率、死亡率、对症治疗及随访情况。结果两组患者均顺利完成手术，观察组患者肿瘤全切除34例（94.44%），对照组患者肿瘤全切除10例（71.43%），两组均未出现死亡病例，观察组患者手术效果明显优于对照组，差异具有显著性（P＜0.05）。结论上矢状窦中后1/3脑膜瘤术前行MRV检查，术中保护回流静脉可提高肿瘤全切除率，改善患者的生存质量。
목적：탐토상시상두중후1/3뇌막류술중보호회류정맥적방법급의의，위학보수술성공제공삼고의거。방법회고성분석본원신경외과2011년8월지2013년8월수치적50례상시상두방중후1/3뇌막류환자적림상자료，안조시부보호회류정맥분위관찰조（36례）화대조조（14례）。관찰조환자행정맥자공진혈관성상（MRV）검사，명학상시상두통창정도여뇌막류주변정맥회류대상정황，술중진량보호회류정맥급정상뇌조직，타선처리수루시상두。대조조환자채용전통수술방식치료，미평개시상두통창정황，미보호회류정맥。의거Simpson표준평개종류절제정도，비교량조환자종류전절솔、사망솔、대증치료급수방정황。결과량조환자균순리완성수술，관찰조환자종류전절제34례（94.44%），대조조환자종류전절제10례（71.43%），량조균미출현사망병례，관찰조환자수술효과명현우우대조조，차이구유현저성（P＜0.05）。결론상시상두중후1/3뇌막류술전행MRV검사，술중보호회류정맥가제고종류전절제솔，개선환자적생존질량。
Objective To investigate the superior sagittal sinus meningiomas after surgery 1/3 veins protection method and its significance in order to ensure successful operation. Method A retrospective analysis parasagittal meningioma after 1/3 on 50 cases of patients with neurosurgical in our hospital from August 2011 to August 2013 admitted to the clinical data, according to whether the protection of veins into observation group (36 cases ) and control group (14 cases). Observed patients underwent magnetic resonance angiography vein (MRV) examination, the superior sagittal sinus meningiomas surrounding venous patency and ileum compensatory case, try to protect the veins surgery and normal brain tissue, for proper sagittal sinus involvement deal with. Control group used traditional surgical treatment, did not evaluate the sagittal sinus patency, unprotected veins. Simpson based on criteria for evaluating the degree of tumor resection were compared in patients with total resection rates, deaths, symptomatic treatment and follow-up cases. Result All the patients were successfully completed surgery, patients in observation group total tumor resection in 34 cases (94.44%), control group of patients with total tumor resection in 10 cases (71.43%). Two groups were no deaths occurred, observation group operation effect was obviously better than control group, the difference was signiifcant (P<0.05). Conclusion Superior sagittal sinus meningiomas 1/3 MRV preoperative examination, intraoperative protection veins can increase total resection rate, improve the quality of life of patients.