临床神经外科杂志
臨床神經外科雜誌
림상신경외과잡지
JOURNAL OF CLINICAL NEUROSURGERY
2015年
4期
287-290
,共4页
脑膜瘤%侵袭性%诊断%治疗%放疗
腦膜瘤%侵襲性%診斷%治療%放療
뇌막류%침습성%진단%치료%방료
meningioma%aggressive%diagnosis%treatment%radiotherapy
目的：探讨侵袭性脑膜瘤的临床特点和治疗方法。方法对手术治疗的52例侵袭性脑膜瘤患者的临床资料进行回顾性分析。肿瘤位于幕上凸面、镰窦旁、侧脑室内共44例，颅底6例，幕下2例。幕上肿瘤主要采用马蹄形瓣状开颅，幕下采用幕下旁正中切口。颅底肿瘤分别采用翼点、乙状窦后，额下入路。结果52例患者共进行75次手术，其中1次手术34例，2次手术14例，3次手术3例，4次手术1例。手术后24例行普通放疗，4例行适形放疗，11例行γ-刀治疗。SimpsonⅠ级切除30例，Ⅱ级切除10例，Ⅲ级切除11例，Ⅳ级切除1例。出院后共有37例患者得到1个月～11年随访，7例随访到的Ⅲ级脑膜瘤全部复发。Ⅱ级脑膜瘤随访30例，其中16例患者尚未复发，14例患者复发。结论侵袭性脑膜瘤是颅内较少见肿瘤，预后较差。手术切除和手术后辅助放疗是延长患者生存期的重要手段。
目的：探討侵襲性腦膜瘤的臨床特點和治療方法。方法對手術治療的52例侵襲性腦膜瘤患者的臨床資料進行迴顧性分析。腫瘤位于幕上凸麵、鐮竇徬、側腦室內共44例，顱底6例，幕下2例。幕上腫瘤主要採用馬蹄形瓣狀開顱，幕下採用幕下徬正中切口。顱底腫瘤分彆採用翼點、乙狀竇後，額下入路。結果52例患者共進行75次手術，其中1次手術34例，2次手術14例，3次手術3例，4次手術1例。手術後24例行普通放療，4例行適形放療，11例行γ-刀治療。SimpsonⅠ級切除30例，Ⅱ級切除10例，Ⅲ級切除11例，Ⅳ級切除1例。齣院後共有37例患者得到1箇月～11年隨訪，7例隨訪到的Ⅲ級腦膜瘤全部複髮。Ⅱ級腦膜瘤隨訪30例，其中16例患者尚未複髮，14例患者複髮。結論侵襲性腦膜瘤是顱內較少見腫瘤，預後較差。手術切除和手術後輔助放療是延長患者生存期的重要手段。
목적：탐토침습성뇌막류적림상특점화치료방법。방법대수술치료적52례침습성뇌막류환자적림상자료진행회고성분석。종류위우막상철면、렴두방、측뇌실내공44례，로저6례，막하2례。막상종류주요채용마제형판상개로，막하채용막하방정중절구。로저종류분별채용익점、을상두후，액하입로。결과52례환자공진행75차수술，기중1차수술34례，2차수술14례，3차수술3례，4차수술1례。수술후24례행보통방료，4례행괄형방료，11례행γ-도치료。SimpsonⅠ급절제30례，Ⅱ급절제10례，Ⅲ급절제11례，Ⅳ급절제1례。출원후공유37례환자득도1개월～11년수방，7례수방도적Ⅲ급뇌막류전부복발。Ⅱ급뇌막류수방30례，기중16례환자상미복발，14례환자복발。결론침습성뇌막류시로내교소견종류，예후교차。수술절제화수술후보조방료시연장환자생존기적중요수단。
Objective To explore clinical feature and therapeutic experiences of aggressive meningiomas.Methods The clinical dada of 52 patients with aggressive meningiomas who received the operation,were analyzed retrospectively.Of 52 cases,44 located in cerebral convexity, parasagital ,parafalx and lateral ventricle,6 located in skull-base and 2 located in infratentorial space.Craniotomy of supratentorial tumors was performed through supratentorial horseshoe incision. Craniotomy of infratentorial tumors was performed through paramedian incision.Tumors of skull-base was performed through pterion approach,retrosigmoid approach and subfrontal approach respectively. Results 75 operations were carried out for 52 patients.Of them,only one operation for 34 patients, second operation for 14 patients,third operation for 3 patients,fourth operation for 1 patient.24 patients underwent additional adjuvant general radiotherapy,4 patients underwent conformal intensity-modulated radiotherapy and 11 patients underwent Gamma-knife radiotherapy.Simpson grade I resection was achieved for 30 patients,Simpson grade Ⅱ resection for 10 patients,Simpson grade Ⅲresection for 11 patients,and Simpson grade Ⅳ resection for 1 patients.37 patients were followed up from one month to 11 years.Recurrences occurred for all 7 Grade Ⅲ meningioma patients.Of 30 followed-up Grade Ⅱ meningioma patients,no recurrences occurred for 16 patients,recurrences occurred for 14 patients.Conclusions Aggressive meningioma were rare intracranial tumor.Its prognosis was poor.Surgical resection followed by radiotherapy were key means to prolong survival time of patients.
