摘要
目的:研究断颧弓扩大翼点入路在蝶骨嵴大型脑膜瘤手术切除中的运用。方法:分析遵义医学院附属医院2013年5月至2016年4月收治的蝶骨嵴内侧大型脑膜瘤患者53例,其中33例蝶骨嵴大型脑膜瘤采用断颧弓扩大翼点入路手术,20例蝶骨嵴大型脑膜瘤采用传统翼点入路为对照组。比较两组间切除率、手术时间、术中出血、术后并发症。结果:两组患者均在显微镜下行开颅手术,断颧弓组SimponⅠ、Ⅱ级切除率为93.9%,对照组60.0%(P<0.01);手术时间为(325.2±121.3)min,短于对照组(406.4±182.9)min(P<0.05);两组术中出血量分别为(502.5±101.8)mL、(697.7±115.4)mL(P<0.05);断颧弓入路组术后并发症发生率为15.2%,对照组为45.0%(P<0.05),两组均无死亡病例。结论:断颧弓扩大翼点入路能够充分暴露中颅底及鞍旁重要解剖结构,消除颞肌对术区暴露的影响,充分暴露术野,减少对额颞叶脑组织牵拉损伤,有助于蝶骨嵴大型脑膜瘤的完整切除,更有利于神经血管的解剖及功能保护。
Objective：To explore the application of extensive pterional approach combined with cutting of the zygomatic arch for the resection of large sphenoid ridge meningioma.Methods：Thirty-three patients with large sphenoid ridge meningioma underwent operation using the extensive pterional approach combined with cutting of the zygomatic arch.Twenty patients with large sphenoid ridge meningioma received operation with the traditional pterional approach as the control.The resection rate,operative time,intraoperative blood loss,and postoperative complications were compared between the groups.Results：Two groups of patients underwent craniotomy under microscope.The Simpon grade I resection and grade Ⅱ resection rate was 93.9% in the cutting of the zygomatic arch approach group and 60.0% in the control group（P〈0.01）.The operative time was（325.2 ± 121.3） min in the cutting of the zygomatic arch approach group,which was significantly shorter than that in the control group with（406.4±182.9） min（P〈0.05）.The intraoperative blood loss was（502.5±101.8） mL and（697.7±115.4） mL in the two groups（P〈0.05）.In addition,postoperative complication rate was 15.2% and 45.0% in the cutting the zygomatic arch approach group and the control group,respectively（P〈0.05）.No death was reported in both groups.Conclusion：Extensive pterional approach combined with cutting of the zygomatic arch can fully expose the anatomical structures of the skull base and the sellar region to eliminate the influence of temporal muscle in the exposure of the surgical area.The operative field is exposed to reduce the stretch injury to only the frontotemporal brain tissue,which might be helpful for the complete resection of large sphenoid ridge meningioma,and is more conducive to neurovascular anatomy and relevant functional protection.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2017年第16期822-825,共4页
Chinese Journal of Clinical Oncology
关键词
扩大翼点断颧弓
蝶骨嵴
脑膜瘤
疗效
extensive pterional approach combined with cutting of the zygomatic arch, sphenoid ridge, meningioma, curative effect
