目的对在显微镜下手术的颅底脑膜瘤患者进行回顾、分析,以提高其效果及生活质量.方法按肿瘤生长部位不同,选择不同的手术入路.在切瘤过程中常规使用Zeis显微镜进行手术操作.部分未能全切者术后辅以γ-刀放射治疗.结果26例病例中全切除23例,大部分切除2例,部分切除1例.本组术后无死亡病例.神经功能及症状体征加重1例.3例原术前有癫痫发作患者经手术及术后行抗癫痫治疗后痊愈.余全部都有不同程度恢复、好转或痊愈.结论颅底脑膜瘤是血运异常丰富的实质性肿瘤,且颅底解剖复杂,凹凸不平,视野视角狭小多变,仍是专科的技术难点、热点之一.笔者认为:对血管异常丰富、风险较大者,术中使用高速磨钻扩大视野,骨窗要尽量贴近颅底,降低颅压及充分暴露肿瘤,使用显微操作技术,才能提高手术安全性及手术效果,减少并发症的发生,而显微技术是手术成功、安全的关键.“,”Objective Throuhg reviews and analysis of microsurgery in cranial base meningioma to improve the effect of surgery and the quality of life in patients.Methods Various surgical approaches were chosen according to the position of tumor.Zeis microscope was routinely used during the tumor resection.Embolization of vessels was taken in few patients before surgery.Some patients failed to total removal were assisted with gamma knife afterwards.Results Of the 26 patients,total resection of tumor were achieved in 23 cases,most resection in 2, partial in 1,no death case.One patient was with aggravated nerve functions,symptoms or signs.Three patients with seizure were al cured after treating with antiepileptic therapy during and post surgery.The rest of patients were in different degree of recovery,improvement or cure.Conclusion Cranial base meningioma is one kind of solid tumor with rich blood supply, and the skul base anatomy is complicated and vision field is limited and variable,thus it remains one of the technical difficulties and hotspots in neurosurgery field.In our opinion,to those patients with abundant vessels tumors,embolization of vessels should be taken before surgery.During the surgery,high speed dril wil help to widen the vision field,bone window should be low enough to close the skul base.And intracranial pressure should be decreased,tumor should be exposed adequately.Microsurgery technique can improve the safety and effect of surgery,reduce complications,which plays the key role in the success and safety of surgery.