颅内巨大脑膜瘤的外科手术治疗

目的总结颅内巨大脑膜瘤外科手术治疗经验和技巧。方法回顾性分析2006～2010年在神经外科治疗的36例巨大脑膜瘤病人的临床特征、手术方法和疗效。结果按照脑膜瘤切除的Simpson分级标准,肿瘤Ⅰ级切除18例,Ⅱ级切除12例,Ⅲ级切除5例,Ⅳ级切除1例。术后28例病人症状明显缓解,2例症状加重,死亡1例,复发5例。结论手术切除是治疗颅内脑膜瘤的有效手段,巨大脑膜瘤因质韧和血供丰富,加之有些肿瘤部位特殊,手术有相当的难度,术者可根椐肿瘤部位选择正确的手术入路,尽可能运用显微神经外科技术,保护好重要神经、血管及组织结构,有助于提高巨大脑膜瘤全切除率,降低肿瘤复发率。

Surgical therapy of intercranial giant meningiomas

Objective To summarize the experience and skills of surgical treatment of intracranial giant meningiomas.Methods The clinical characteristics,surgical methods and results of 36 cases of intracranial giant meningioma treated in our department were analyzed.Results According to the meningioma resection Simpson grading,SimpsonⅠ,Ⅱ,Ⅲ and Ⅳ resection were achieved in 18,12,5 and 1 cases,respectively.Postoperative symptoms of 28 patients were relieved,2 patients symptoms worsened,and 1 died,5 cases of recurrence.Conclusion Surgical resection is an effective means of treatment of intracranial giant meningiomas.Tough because of the hard quality and rich blood supply,combined with specific location of some tumor,giant meningiomas is difficult to resect.The surgeon can choose the correct surgical approach,use of neurosurgery technology,protect important nerves,blood vessels and organizational structure,it is helpful to improve resection rate and lower recurrence rate of intracranial giant meningioma.