蝶骨嵴内1/3脑膜瘤显微手术治疗的探讨

目的探讨蝶骨嵴内1／3脑膜瘤显微手术治疗情况。方法对11例经显微外科手术治疗蝶骨嵴内1／3脑膜瘤进行回顾性分析。结果11例患者中肿瘤全切除（Simpson Ⅰ、Ⅱ）9例，近全切除2例，无手术死亡。术中证实肿瘤基底部主要位于前床突的尖部、根部内、外侧部及周围延伸。术后5例（45％）患者出现脑血管痉挛伴有一过性肢体运动障碍的脑缺血、水肿症状，神经继发损伤症状。结论显微手术切除是蝶骨嵴内1／3脑膜瘤最有效的治疗方法，掌握全面的解剖知识和熟练的手术技巧，选择恰当的手术入路，良好的肿瘤显露、成功的肿瘤切除及术后并发症的及时处理是显微外科治疗的关键。

Microsurgical treatment of the inner 1/3 sphenoid meningioma

objective To investigate the microsurgical treatment of the inner 1/3 sphenoid meningioma.Methods 11 cases with the inner 1/3 sphenoid meningioma who underwent microsurgical treatment were analyzed retrospectively.Results The tumors were total resected in 9 cases,and the others were sub-totally resected.No mortality.The bases of the tumors were mainly arounded the anterior clinoid process.5cases(45%)were complicated by cerebral vascular spasm,cerebral edema and cerebral ischemia which resulted in paresis of limbs.Conclusions Microsurgical treatment was the most effective treatment of the iuner 1/3 sphnoid meningioma.Mastering the anatomy and the operative skill,choosing the operative approach correctly,exposing the tumors sufficiently,removing the tumors completely,handling the complications timely were the main points of microsurgical treatment.