大型、巨大型岩斜区脑膜瘤的显微外科治疗-外科学(神经外科学)专业论文.docx

新疆医科大学硕士学位论文 新疆医科大学硕士学位论文 PAGE PAGE 1 大型、巨大型岩斜区脑膜瘤的显微外科治疗 研究生：王丙乾 导师：更·党木仁加甫 教授 摘 要 目的：探讨岩斜区脑膜瘤患者手术切除的程度，总结显微外科手术切除经验。 方法：回顾性分析 26 例大型、巨大型岩斜区脑膜瘤病人的临床资料，肿瘤最大径≥ 2.5cm，病灶主体均位于岩斜区，采用显微外科手术切除肿瘤，其中颞下经小脑幕入 路 7 例，枕下乙状窦后入路 15 例，幕上、下联合入路（颞下入路联合乙状窦后入路） 2 例，眶颧入路 2 例。结果：脑膜瘤切除程度：全切（SimpsonⅠ、Ⅱ级）12 例，次 全切（SimpsonⅢ级）4 例，大部切除（SimpsonⅣ级）10 例。结论：术者应追求肿 瘤最大程度切除与尽可能低的术后并发症的平衡点，避免盲目的追求全切肿瘤，根 据肿瘤大小、生长方式、侵犯区域等因素个性化选择不同显微手术入路。 关键词 脑膜瘤；岩斜区；显微外科 Microsurgery for large and giant petroclival meningioma Postgraduate: Wang Bingqian Supervisor: Prof.Dang Muren Abstract Objective: To investigate the extent of tumor resection,to summarize the experience of microsurgical removal of the large and giant petroclival meningioma. Method: We retrospectively reviewed the medical records of 26 patients treated surgical for a large or giant petroclival meningioma.Tumor maximum diameter=2.5cm.Lesions subject are located in the petroclival area.7 cases were conducted with subtemporal transpetrosal,15 with retrosigmoid approach,2 with Supra- infratentorial approach(subtemporal and retrosigmoid sinus combined approach),2 wih orbitozygomatic approach.Result: Of all patients in this group, gross total resection(Simpson Grade I or II)was achieved in 12 patients,subtotal resection(Grade III)was achieved in 4 patients,partial resection(Simpson Grade Ⅳ) was achieved in 10 patients. Conclusion: To avoid blind pursuing gross total resection of tumors,and to find the balance between the extent of tumor resection and reducing postoperative complications.Different surgical approaches should be chosen according to different kinds of large and giant petroclival meningioma,according to’the size, growth pattern and encroachment area,etc. Key words ：Meningioma;Petroclivus;Microsurgery 中英文缩略词对照表 英文缩写 英文全名 中文译名 DSA digital subtract angiography 数字减影血管造影 术 CT computed tomography 计算机体层成像 MRI magnetic resonance imaging 磁共振成像 论文独创性说明 本人申明所呈交的学位论文是在我个人在导师的指导下进行的研 究工作及取得的研究成果。尽我所知，除了文中特别加以标注和致谢的 地方外，论文中不包含其他人已经发表或撰写过的研究成果。与我一同