小脑幕脑膜瘤显微外科治疗

摘要

ObjectiveTo improve the surgical results for patients with tentorial meningioms.Method Forty-one patients with tentorial meningiomas who underwent surgical treatment in our department from 2008 to 2013 were enrolled into this retrospective study. Surgical approaches according to the locations of the tumors and patients’ outcomes were correlated and analyzed.ResultSimpson grade I resections were achieved in twenty-seven patients, resulting in the disappearance or alleviation of symptoms in twenty-five patients, injury of brain stem andⅣ&Ⅴnerve in one patient, death due to venous infarction in one patient. Simpson gradeⅡresections were achieved in twelve patients, leading to disappearance or alleviation of symptoms in eleven patients, focal infarction of superior surface of cerebellum in one patient. Simpson gradeⅢ resections were achieved in the remaining two patients with the disappearance of their symptoms without complications.ConclusionSurgical strategy based on the locations of the tumors and comprehensive acknowledgement of the neighboring anatomy may offer the patients with tentorial meningiomas better chance of more complete removal with decreased mobility and mortality.%目的：分析小脑幕脑膜瘤的手术效果，寻找减少并发症发生的方法。方法对2008～2013年收治的41例小脑幕脑膜瘤进行回顾性分析与总结。结果 Simpson Ⅰ级切除27例，25例术后症状消失或减轻并未出现新的症状和体征，1例出现脑干损伤伴滑车及三叉神经损伤，1例脑膜间窦被阻断发生静脉性脑梗死后出血死亡；SimpsonⅡ切除的12例中11例症状消失或减轻，1例出现小脑上面小范围静脉性梗死，未留下后遗症状；SimpsonⅢ级切除2例术后症状消失。结论根据肿瘤部位选择不同的手术入路，术前了解各个病例的局部解剖结构，掌握手术尺度，可减少并发症的发生，提高手术效果。