CAJ | 학술논문

目的：探讨小脑幕脑膜瘤的临床分型、手术入路及显微手术治疗的要点。方法回顾分析我科经显微手术治疗的48例小脑幕脑膜瘤患者的临床资料，包括临床症状、影像学表现、手术过程及术后并发症，并采用格拉斯哥预后评分(GOS)对术后患者的预后情况进行评估。结果48例小脑幕脑膜瘤患者中，肿瘤SimpsonⅠ级全切除24例(50%)，SimpsonⅡ级切除17例(35.4%)，SimpsonⅣ切除7例(14.6%)。对39例患者进行了术后随访，随访时间为4个月至5年，其中预后良好30例，预后不良9例(包括死亡2例)。结论合理选择恰当的手术入路，术中应用显微手术技术妥善保护和处理颅神经、静脉窦、脑干等重要结构，可大大提高小脑幕脑膜瘤的切除程度，减少并发症的发生，对提高患者术后生活质量具有重要临床意义。
목적：탐토소뇌막뇌막류적림상분형、수술입로급현미수술치료적요점。방법회고분석아과경현미수술치료적48례소뇌막뇌막류환자적림상자료，포괄림상증상、영상학표현、수술과정급술후병발증，병채용격랍사가예후평분(GOS)대술후환자적예후정황진행평고。결과48례소뇌막뇌막류환자중，종류SimpsonⅠ급전절제24례(50%)，SimpsonⅡ급절제17례(35.4%)，SimpsonⅣ절제7례(14.6%)。대39례환자진행료술후수방，수방시간위4개월지5년，기중예후량호30례，예후불량9례(포괄사망2례)。결론합리선택흡당적수술입로，술중응용현미수술기술타선보호화처리로신경、정맥두、뇌간등중요결구，가대대제고소뇌막뇌막류적절제정도，감소병발증적발생，대제고환자술후생활질량구유중요림상의의。
Objective To discuss clinical classification, surgical approaches and microsurgery techniques in the treatment of tentorial meningiomas. Methods Clinical data of 48 patients were retrospectively analyzed, including clinical symptoms, imaging findings, surgical procedures and postoperative complications, and the Glasgow Outcome Scale (GOS) was used to assess the prognosis of the patients. Results Among 48 patients, Simpson GradeⅠresection was achieved in 24 patients(50%), Simpson GradeⅡresection was achieved in 17 patients(35.4%), Simpson GradeⅣresection was achieved in 7 patients(14.6%). 39 patients were postoperative follow up from 4 months to 5 years, 30 patients with favourable prognosis, 9 patients with unfavourable prognosis (including two cases of death). Conclusion Selecting the appropriate surgical approach, and relying on the application of microsurgical technique properly to protect the cranial nerves, sinus, brainstem and other important structures, may raise the total removal rate for tentorial meningioma, and reduce the incidence of complications. It has important clinical significance to improve the postoperation life quality.