颅底中央区脑膜瘤的显微外科治疗

目的 探讨颅底中央区脑膜瘤治疗策略和手术的一些原则问题。方法 回顾分析我科自1990年至2002年收治的生长于颅底中央区的脑膜瘤103例。结果 病变切除达到Simpson1、2级病例所占百分比为:鞍结节及鞍隔脑膜瘤94％(16/17),前床突及蝶骨嵴内侧脑膜瘤78％(28/36),岩斜区及蝶岩斜区脑膜瘤68％(26/38),海绵窦脑膜瘤58％(7/12)。死亡率约4％,术后早期严重井发症发生率16％。结论 对于颅底中央区难治性脑膜瘤,采取积极的外科手术态度和小心谨慎的操作,可使2/3或更多的病例获得全切除,而其中2/3以上病人获得良好生存。

Microsurgical Treatment of Meningiomas in the Central Region of the Skull Base

Objectives To evaluate the surgical strategy and operative principle in the patients with meningiomas involving the central region of the skull base. Methods The clinical dada of 103 patients with meningiomas involving the central region of the skull base, who were hospitalized in our department from 1990 to 2002, were analyzed retrospectively. Results The rates of total tumor resection achieved Simpson 1-2 grade were as follows: 94% (16/17) in tuberculum sellae and diaphragm sellae meningiomas, 78% (28/36) in anterior clinoid process meningiomas, 68% (26/38) in petroclival meningiomas and 58% (7/12) in cavernous sinus meningiomas. The mortality was 4% and the morbidity in early postoperative stage was 16%. Conclusions Active and Cautious surgical resection of meningiomas involving the central region of the skull base may obtain radical tumor resection in about two-thirds of the patients, and among them, over two-thirds can achieve good outcome.