摘要
目的探讨鞍区脑膜源性肿瘤根治性切除和视神经管减压对于鞍区脑膜源性肿瘤患者术后视力的影响。方法收集2010年1月至2012年10月手术治疗的鞍区脑膜源性肿瘤中的脑膜瘤和血管外皮瘤切除术44例患者的临床资料，回顾性分析肿瘤切除程度的Simpson分级、肿瘤粘连程度、视神经管减压和患者临床预后及视力转归的关系，并结合文献进行对比分析。结果44例患者中SimpsonI级切除31例，术中显示有明显肿瘤和重要结构粘连者9例，磨开视神经管17例，术后追踪视力好转者17例，视力维持不变者11例，视力恶化者3例。SimpsonⅡ级切除8例和SimpsonⅢ级切除5例，共13例中，术中显示存在明显瘤体粘连者10例，磨开视神经管3例，术后追踪视力好转8例，视力维持不变4例，视力恶化1例。肿瘤切除程度SimpsonⅠ级与Ⅱ级和Ⅲ级之间的术后视力差异无统计学意义（P〉0．05）；肿瘤粘连降低肿瘤全切除率的差异有统计学意义（P〈0．05）。磨开视神经管患者的术后视力优于未磨开者（P〈0．05）。结论鞍区脑膜源性肿瘤与重要结构的粘连影响肿瘤的切除程度，有条件的肿瘤根治性切除没有影响术后视力，磨开视神经管在一定程度上可以改善术后的视力。
Objective To investigate the influence of the radical resection and the optic canal unroofing on the postoperative vision in the patients with tuberculm region meningeal tumors. Matheods A retrospective analysis was made in 44 patients with tuberculm region meningeal tumors, from January 2010 to October 2012. The clinical data including the Simpson grades, adhesion between tumor and the surrounding structures, optic canal decompression, and postoperative vision were studied, and followed-up. Results In all 44 cases, there were 31 patients with Simpson grade I resection, their postoperative vision of 17 patients were improved, eleven unchanged, and 3 worse. Out of them, tumors showed more adhesive in 9 cases, unroofed the optic canal in 17 cases. There were 13 cases in the other group including 8 cases with Simpson grade II and 5 cases with Simpson grade i, their postoperative vision of 8 patients were improved, four unchanged, and 1 worse. Out of them, tumors showed more adhesive to the surroundings in 10 cases, unroofed the optic canal in 3 cases. There were no different postoperative vision among the Simpson grades by the Chi-Square test （ P 〉 0. 05 ）. The less adhesive of the meningeal tumors, the better resection grade would be （P 〈 0. 05 ）. And unroofed the optic canal group showed better postoperative vision than the not unroofed ones （P 〈 0. 05 ）. Conclusion In the tubereulum region meningeal tumors, the Simpson resection grade was related to adhesion between the meningeal tumors and the surroundings, not to postoperative vision. The optic canal decompression can improve their visual outcome in some cases.
出处
《中华显微外科杂志》
CSCD
北大核心
2013年第5期431-435,共5页
Chinese Journal of Microsurgery
关键词
鞍区
脑膜瘤
视力
视神经管减压
显微神经外科
Tuberculum region
Meningioma
Vision
Optical canal decompression
Mieroneurosurgery
