CAJ | 학술논문

目的探讨侧脑室脑膜瘤手术入路选择和显微外科技巧对术后疗效及并发症发生率的影响.方法回顾性分析天津环湖医院神经外科自2006年10月至2014年10月8年间,手术治疗47例侧脑室脑膜瘤患者临床资料.依肿瘤的位置和发展方向不同,分别采用顶枕部入路38例和颞中回皮层入路9例,其中32例应用神经导航技术,26例应用术中超声技术.结果 38例患者采用顶枕部入路,37例肿瘤全切除(Simpson Ⅰ级),大部分切除(SimpsonⅣ级)1例;9例颞中回皮层入路,均为肿瘤全切除.术后颅内高压症状不同程度缓解30例;偏盲症状术后得到改善9例,2例加重及新出现1例;共济失调等运动障碍好转8例;2例患者因脑积水分别行脑室-腹腔分流术和穿刺引流术.本组29例术后随访3个月～8年(平均47个月),2例复发再次行手术治疗.结论侧脑室脑膜瘤首选手术治疗.选择合适的手术入路,辅助神经导航及术中超声等技术,可降低术后并发症发生率,并取得良好的手术效果.
목적 탐토측뇌실뇌막류수술입로선택화현미외과기교대술후료효급병발증발생솔적영향.방법 회고성분석천진배호의원신경외과자2006년10월지2014년10월8년간,수술치료47례측뇌실뇌막류환자림상자료.의종류적위치화발전방향불동,분별채용정침부입로38례화섭중회피층입로9례,기중32례응용신경도항기술,26례응용술중초성기술.결과 38례환자채용정침부입로,37례종류전절제(Simpson Ⅰ급),대부분절제(SimpsonⅣ급)1례;9례섭중회피층입로,균위종류전절제.술후로내고압증상불동정도완해30례;편맹증상술후득도개선9례,2례가중급신출현1례;공제실조등운동장애호전8례;2례환자인뇌적수분별행뇌실-복강분류술화천자인류술.본조29례술후수방3개월～8년(평균47개월),2례복발재차행수술치료.결론 측뇌실뇌막류수선수술치료.선택합괄적수술입로,보조신경도항급술중초성등기술,가강저술후병발증발생솔,병취득량호적수술효과.
Objective To investigate the effects of the selection of surgical approaches of lateral ventricular meningiomas and microsurgical skills on postoperative efficacy and complication rate.Methods The clinical data of 47 patients with lateral ventricular meningioma operated at the Department of Neurosurgery,Tianjin Huanhu Hospital from October 1 2006 to October 1 2014 were analyzed retrospectively.The patients were treated via parietooccipital approach (n =38) and temporal gyrus cortex approach (n =9) according to the different locations and directions of tumors.Thirty-two of them used neuronavigation and 26 used intraoperative ultrasound technology.Results Thirty-eight patients were treated via parietooccipital approach,the tumors of 37 patients were resected totally (Simpson grade Ⅰ),and 1 was resected subtotally (Simpson grade Ⅳ).Nine patients were treated via temporal gyrus approach and their tumors were resected totally.The symptoms of intracranial hypertension of 30 patients were relieved with varying degrees after procedure;the symptoms of hemianopsia of 9 patients were improved after procedure,2 aggravated,and 1 was a new case;ataxia and other movement disorders of 8 patients were improved;2 patients underwent ventricle-peritoneal shunt and puncture drainage respectively because of hydrocephalus.In this group,29 patients were followed up for 3 months to 8 years (mean 47 months) after procedure.Two patients had recurrence and were reoperated.Conclusions Lateral ventricle meningioma prefers surgical treatment.Choosing appropriate surgical approaches with the help of neuronavigation and intraoperative ultrasound and other techniques may decrease the postoperative complication rate and achieve good operation effect.