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目的提高侵及颅内主要静脉系统脑膜瘤手术的全切率,总结利用显微外科技术切除肿瘤和处理颅内静脉系统的经验和技巧。方法我院1991年7月至2001年7月,手术治疗300例侵及颅内主要静脉系统的脑膜瘤,包括(1)矢状窦旁脑膜瘤;(2)大脑镰旁脑膜瘤;(3)小脑幕脑膜瘤;(4)横窦和窦汇区脑膜瘤;(5)镰幕脑膜瘤;(6)海绵窦脑膜瘤;(7)乙状窦脑膜瘤;(8)颈静脉孔区脑膜瘤。视肿瘤部位采用相应的手术入路,根据静脉系统受侵及的程度做不同的处理。结果按脑膜瘤切除的Simpson’s分级,其中Ⅰ、Ⅱ级为全切除,全切率为86.7%,死亡率为1.7%。结论当脑膜瘤侵及不同的硬脑膜静脉窦或重要的颅内静脉时,手术处理方法不同。采用显微神经外科技术可提高脑膜瘤的全切率,并降低死亡率。
Objective To increase the rate of total invasion of the major intracranial venous system meningiomas and summarize the experience and skills of using microsurgery to remove tumors and treat the intracranial venous system. Methods From July 1991 to July 2001, 300 cases of meningiomas invaded the main intracranial venous system were treated surgically in our hospital, including (1) parathyroid meningioma; (2) falx paraneoplastic meningioma; (3) ); Cerebellar meningioma; (4) transverse sinus and sinus area meningioma; (5) sickle meningioma; (6) cavernous sinus meningioma; (7) sigmoid sinus meningioma; Meningioma. Depending on the tumor site using the appropriate surgical approach, depending on the extent of the venous system to do different treatment. Results According to the Simpson’s classification of meningioma resection, the total resection rate was 86.7% and the mortality rate was 1.7%. Conclusion When the meningiomas invade different dural venous sinus or an important intracranial vein, the surgical treatment is different. The use of microsurgical neurosurgery increases the rate of meningiomas and reduces mortality.