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目的探讨鞍旁脑膜瘤显微手术的治疗效果。方法对62例行显微手术治疗的鞍旁脑膜瘤患者的临床资料及手术效果进行分析总结。结果42例全切(SimponⅠ,Ⅱ),16例次全切(SimponⅢ),4例大部分切除,术中去骨瓣减压4例,无手术死亡。术后早期出现同侧动眼神经瘫12例,滑车和外展神经功能障碍8例,对侧肢体轻瘫4例。肿瘤未全切的20例患者中有11例术后行放射治疗。随访3~38个月,动眼神经瘫恢复5例,滑车和外展神经功能恢复3例,肢体活动障碍恢复2例,4例术中去骨瓣减压的患者有2例已行颅骨缺损修补。全切病例中,10例患者有肿瘤复发,4例行二次手术,6例行放射治疗,失访4例。结论鞍旁脑膜瘤显微手术的治疗效果良好,但鞍旁脑膜瘤与颅底血管神经关系密切,所以手术操作要精细。
Objective To investigate the effect of microsurgical treatment of parasellar meningioma. Methods 62 cases of microsurgical treatment of patients with parasellar meningioma clinical data and surgical results were analyzed and summarized. Results Forty - two patients underwent Simpon Ⅰ, Ⅱ and Simpon Ⅲ resection. Four patients underwent partial resection and four patients underwent decompressive craniectomy. No operative death occurred. Early postoperative ipsilateral oculomotor nerve paralysis in 12 cases, pulley and abducens nerve dysfunction in 8 cases, contralateral limb paralysis in 4 cases. Of the 20 patients who had not undergone tumor resection, 11 received radiotherapy. During 3 to 38 months of follow-up, 5 cases recovered oculomotor palsy, 3 cases recovered the function of the block and abducens, 2 cases recovered the active limbs, 2 cases had skull defects repair. Totally 10 cases had tumor recurrence, 4 cases underwent second surgery, 6 cases underwent radiotherapy and 4 cases lost to follow-up. Conclusions The treatment of parasellar meningiomas is effective in microsurgery. However, the parasellar meningiomas are closely related to the cranial nerves, so the operation should be fine.