鞍结节脑膜瘤42例临床分析

目的探讨鞍结节脑膜瘤的诊断及治疗.方法对42例鞍结节脑膜瘤的临床资料进行回顾性分析.结果肿瘤全切除28例,次全切除9例,部分切除5例,其中颅底重建5例.术后55%病人视力改善,大部分病人恢复正常工作.结论对首发症状为视力视野改变特别是伴持续性头痛者,应行CT或MRI检查,争取早期确诊;肿瘤形状及生长方向是影响肿瘤切除的主要因素,应肿瘤的大小及生长方向确定手术入路;细致的显微手术可以避免损伤鞍区的重要结构,对有颅底骨质破坏者需行颅底重建;应对鞍结节脑膜瘤进行细致分型,从而更有利于手术及估计预后.

Clinical study on 42 cases meningiomas of the tuberculum sellae.

Objective To study the diagnosis and treatment of meningiomas of the tuberculum sellae. Methods Retrospec- tive analysis of the clinical materials of 42 patients who were treated in our hospital from 1991-2000. Results We performed total removal in 28 patients subtotal removal in 9 patients and partial removal 5 patients. Reconstruction of the skull base was required in 5 patients. 53 percent had visual improvement, most of which returned to normal work. Conclusions In patients with impar- imed visual acuity and defect in visual fields as the presenting symptom, particularly those with persistent headache, CT or MRI ex- amination is needed. Operative approach may partly depend on the ske and growth direction of the minor while the shape and growth direction of the tumor determine the degree of resection. Careful microsurgical surgery is required to avoid damage to the im- portant structures locateded in the sella region. Reconstruction of the skull base is needed in patients with bone destruction. A more detailed classification of the meningiomas in the tuberculum sellae is needed to guide operation apporach and to predict prognosis