侧脑室三角区脑膜瘤的显微手术治疗

目的 探讨侧脑室三角区脑膜瘤手术方法及其疗效。方法 2008年3月至2015年8月手术治疗侧脑室三角区脑膜瘤47例，采用经皮层入路25例、经脑沟入路22例。结果 47例肿瘤按SimpsonⅠ级全部切除，无手术死亡病例。经脑沟入路术后并发症发生率（22.7%）明显低于经皮层入路（60.%；P<0.05）。47例术后随访1~12个月，平均为6个月。神经系统功能障碍有不同程度地改善，复查ct、mri未见肿瘤复发；按gos评分评估预后，经脑沟入路手术的患者中，5分12例（54.5%），4分7例，3分2例，2分1例；经皮层入路手术的患者中，5分2例（8.0%），4分4例，3分8例，2分11例；两者预后良好率差异显著（>P<0.05）。>结论 经脑沟入路切除侧脑室三角区脑膜瘤符合微侵袭手术理念，术中辅助超声可以提高肿瘤的全切率并降低术后并发症的发生率，预后也较好，是较理想的手术方式；但是对于肿瘤较大、颅内压明显增高的患者，采用经皮层入路是较好的选择。

Microsurgery for meningiomas in the trigones of lateral ventricles (report of 47 cases)

Objective To investigate the different microsurgical fashions treating the ventricular meningiomas in the trigones of lateral ventricles and their effects on them. Method The clinical data of 47 patients with meningiomas in the trigones of lateral ventricles, of whom, 25 were treated by microsurgery via transcortical approach and 22 were treated via trans-sulcal approach, from March, 2008 to August, 2015, were analyzed. Results Total resection of the tumors was reached in all the patients. No patient died from the microsurgery. The incidence of postoperative complication in the patients treated by the microsurgery via trans-sulcal approach is significantly lower than that in the patients by the microsurgery via transcortical approach (P<0.05).>Conclusions The microsurgery via trans-sulcal approach can reduce the incidence of the postoperative complications in the patients with meningiomas in the trigones of lateral ventricles treated by microsurgery because it is of less side-injury of operation and intra-operative ultrasound may be used. But the microsurgery via tanscortical approach should be recommended in the patients with huge trigonal meningiomas.