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经颅显微手术治疗鞍结节脑膜瘤
张少雄1,陈宏颉2*,王守森2
0
(1.福建省石狮市医院神经外科,石狮 362700;2.南京军区福州总医院,福州 350025)
摘要:
目的:总结鞍结节脑膜瘤经颅显微手术技巧。方法:回顾2003年1月至2009年5月期间我院收治的45例鞍结节脑膜瘤患者的临床资料,总结经颅显微手术技巧,分析影响预后的因素。结果:SimpsonⅠ级切除者8例,其余均Ⅱ级切除;术后视力改善28例,视力无变化15例,视力恶化2例。大型肿瘤术前视力显著下降者,术后视力多恢复不理想。结论:鞍结节脑膜瘤经颅显微手术治疗需要根据肿瘤大小及其生长方向制定个体化手术方案,术中须仔细辨识和保护鞍区重要结构,提高手术技巧是改善肿瘤切除预后的关键。
关键词:  鞍结节  脑膜瘤  手术入路  肿瘤大小  全切除  视力
DOI:10.3724/SP.J.1008.2009.01299
投稿时间:2009-09-23修订日期:2009-11-16
基金项目:
Microsurgical removal of tuberculum sellae meningioma via transcranial approach
ZHANG Shao-xiong1, CHEN Hong-jie2*, WANG Shou-sen2
(1. Department of Neurosurgery, Hospital of Shishi City of Fujian Province, Shishi 362700, China;2. Fuzhou General Hospital, PLA Nanjing Military Area Command, Fuzhou 350025)
Abstract:
Objective:To summarize our experiment in microsurgical removal of tuberculum sellae meningioma via transcranial approach.Methods: The clinical data of 45 patients with tuberculum sellae meningioma, who were treated by microsurgical resection via different transcranial approaches during Jan. 2003 to May 2009, were retrospectively analyzed. And the factors influencing the prognoses were also analyzed.Results: Eight patients had Simpon grade Ⅰresection and the others had grade Ⅱresection. Postoperatively, the visual damage and optic field defect were improved in 28 cases, remained unchanged in 15 cases, and deteriorated in 2 cases. The vision recovery was not satisfactory in patients who had obvious vision decrease before a complicated surgical removal of tumors.Conclusion: Personalized surgical plan should be selected for resection of tuberculum sellae meningioma according to the size and growth direction of tumors; special attention should be paid to protect the important structures of the sellar region. Improvement of the surgical technique is the key to a better prognosis after resection of tumors.
Key words:  tuberculum sellae meningioma  surgical approaches  microsurgical technique