运动区附近大型脑膜瘤显微手术治疗.docVIP

运动区附近大型脑膜瘤显微手术治疗【摘要】 目的 探讨运动区附近大型脑膜瘤的大小与预后的关系及显微外科治疗方法。方法 回顾分析显微外科治疗52例运动区附近大型脑膜瘤患者的大小与预后的关系、术中神经功能保护及术后神经功能康复方法。结果 肿瘤全切47例(90.4%),近全切5例(9.6%),术后新出现不同程度偏瘫或原有偏瘫体征加重共29例(55.8%),经术后治疗完全康复21例(72.4%),KPS评分5分43例(82.7%),其中大型脑膜瘤33例(94.3%),巨大型10例(58.8%),死亡1例(1.9%)。结论 脑膜瘤的大小分型,如结合具体部位,对临床治疗效果对比分析可能更有指导意义,对运动区附近大型脑膜瘤采用显微外科技术切除,结合适当的手术技术操作,术后对有神经功能损害者早期施行高压氧治疗,可有效提高和改善患者的预后。 【关键词】大型脑膜瘤;临床分型;运动区;显微手术;疗效 Microsurgery for large meningiomas in mortor cortexes TANG Wen-guo,FENG Lin,TANG Xiao-ping,et al.Department of Neurosurgery,Affiliated Hospital of North-Sichuan Medical College,Sichuan 637000,China 【Abstract】 Objective To expiore relation of size and curative effect for large meningiomas in mortor cortexes and method of microsurgery.Methods According to clinical date of 52 patients with large meningiomas in mortor cortexes,who underwent microsurgery,to relation of size and curative effect and protection for function in option and method of restorative function after operation were analyzed retrospectively.Results Total resection was achieved in 47 cases(90.4%),and subtotal in 5 cases(9.6%).New developed hemiplegia or deterioration of original hemiplegia were found in 29 cases(55.8%)and completely disappeared in 21 cases(72.4%)by cure after operation in.Outcome was considered by KPS 5 grades in 43 cases(82.7%),33 cases of large miningiomas(94.3%),10 cases of huge miningiomas(58.8%)among the 43 cases,dead in 1 case(1.9%).Conclusion Toward clinical classification of meningioma size,if coupling specific position,can become more comparable meaning to treating meningiomas.To treating large meningiomas in mortor cortexes,it can improve curative effect to adopt microsurgery and combine suitable operational technique and early treat patients for functionary harm with hyperbaric oxygen. 【Key words】Large miningiomas;Clinical classification;Mortor cortexes;Microsurgery;Curative effect 脑膜瘤是常见的颅内肿瘤,占全部颅内肿瘤的13.4%[1],因绝大多数为良性,病变发展缓慢到临床就诊时多为大型脑膜瘤,手术切除是其首选治疗方案。但在功能区或颅内重要部位,其功能及重要