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目的观察并探讨显微外科手术治疗内侧型蝶骨嵴脑膜瘤临床效果。方法回顾性分析本院2005年1月至2006年1月显微外科手术治疗内侧型蝶骨嵴脑膜瘤患者20例的临床资料。结果全部20例内侧型蝶骨嵴脑膜瘤患者中肿瘤全切16例,肿瘤次全切3例,大部切除1例。术前出现视力损害及视野缺损症状14例患者经手术治疗后,10例患者视力出现不同程度好转,3例视力无改变,1例视力下降;术后2例出现不全偏瘫,经2个月治疗后基本恢复;3例出现动眼神经麻痹,其中2例经3～4个月治疗后基本恢复,1例恢复不佳;无死亡病例出现,效果满意。术后随访2-4年,肿瘤全切患者均未见复发;次全切及大部切除患者中出院后继续接受抗肿瘤治疗,其中2例分别于术后13个月、18个月复发,均接受二次手术治疗,随访未见肿瘤复发。结论微外科手术治疗内侧型蝶骨嵴脑膜瘤疗效显著,可有效提高肿瘤全切率,改善临床症状,减少术后并发症,降低死亡率,具有临床推广使用价值。
Objective To observe and discuss the clinical effect of microsurgical treatment of medial sphenoid ridge meningioma. Methods The clinical data of 20 patients with medial sphenoid ridge meningioma treated by microsurgery in our hospital from January 2005 to January 2006 were retrospectively analyzed. Results Totally 16 cases were resected in all 20 cases of medial sphenoid ridge meningioma, 3 cases were subtotally resected, and 1 case was mostly resected. Preoperative visual impairment and visual field defects in 14 patients after surgery, 10 patients improved visual acuity in varying degrees, 3 cases of visual acuity unchanged, 1 case of visual acuity decreased; 2 cases of incomplete hemiplegia after 2 months of treatment After 3 weeks, the patients recovered, and 3 cases showed oculomotor nerve paralysis. 2 cases recovered after 3 ~ 4 months and 1 case recovered poorly. No deaths occurred and the results were satisfactory. All cases were followed up for 2 to 4 years. No recurrence was found in patients with complete resection of the tumor. After subtotal and subtotal resections, patients were continuously treated with anti-tumor therapy after discharge. Among them, 2 cases relapsed 13 months and 18 months postoperatively, All patients underwent second surgery and no tumor recurrence was observed. Conclusion Micro-surgery for the treatment of medial sphenoid ridge meningioma significant effect, which can effectively improve the rate of tumor resection, improve clinical symptoms, reduce postoperative complications, reduce mortality, with clinical value.