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目的 探讨巨大下斜坡脑膜瘤的手术入路方法。方法 对 16例下斜坡巨大脑膜瘤患者在全麻下经外侧枕下入路显微镜直视下分块切除肿瘤 ,术后加强监护及气管切开 ,保持呼吸道通畅。结果 肿瘤全切 12例 ,次全切 4例 ,镜下全切率达 75 %。后组颅神经保留率 90 % ,无手术死亡。术后随访 1～ 3a ,疗效满意。结论 经外侧枕下入路符合解剖生理要求 ,能充分暴露手术野 ,较全面切除肿瘤 ,降低手术病死率 ,可作为下斜坡肿瘤的首选入路
Objective To discuss the surgical approach of huge downward meningioma. Methods Twenty-six patients with giant meningioma at the lower slope were divided into two groups according to lateral suboccipital approach under general anesthesia. The patients underwent intensive care and tracheotomy to maintain the airway patency. Results Tumor resection in 12 cases, subtotal 4 cases, total resection rate of 75%. The group of cranial nerve retention rate of 90%, no operative death. Follow-up 1 ~ 3a after operation, with satisfactory results. Conclusion The lateral suboccipital approach conforms to anatomical and physiological requirements, which can fully expose the surgical field, compared with the complete removal of the tumor and the reduction of the operative mortality, and can be used as the first choice of the lower slope tumor