中央回区脑膜瘤的显微外科治疗

目的 探讨中央回区脑膜瘤的手术方法和技巧.方法 回顾性分析采用显微外科手术切除15例中央回区脑膜瘤的临床资料,其中肿瘤位于中央前回8例,中央后回5例,中央前后回均受累2例.结果 Simpson Ⅰ级切除9例,Ⅱ级切除5例,Ⅲ级切除1例.无手术死亡,术后功能障碍好转10例,无效5例,新增短期功能障碍6例;随访9-38个月,未见肿瘤复发.结论 中央回区脑膜瘤应在良好功能保护的前提下,力争达到Simpson Ⅰ级切除.准确定位、保护好功能区皮质、加强回流静脉结构和功能的维护是降低中央回区脑膜瘤手术残障率的关键.

Microsurgical techniques and strategies of memingiomas in central gyrus region

Objective To discuss the surgical methods and techniques of meningiomas in central gyrua region.Methods A retrospective analysis was performed on 15 cases of meningiomas in central gyrus region,including tumor in precentral gyrus 8 cases,postcentral gyrus 5 cases,both anterior and posterior central gyrus 2 cases.Results According to Simpson's scale,Simpson Ⅰ,Ⅱ and Ⅲ grade removal was achieved in 9,5and 1 respectively.There was no postoperative death.After a follow-up period ranging from 9 to 38 inonths.preoperative dysfunction was improved in 10 cases,no functional improvement in 5 cases,additional short-term dysfunction in 6 cases.There was no recurred case.Conclusion The surgical treatment of meningiomas in central gyrus region should be in good function under the premise of protection,and strive to achieve Simpson Ⅰ grade excision.Both accurate localization and protection of central gyrus cortex are the keys to reduce postoperative crippling rate in cages with meningiomas in central gyrus region.