摘要
目的探讨枕骨大孔区脑膜瘤的手术方法及其疗效。方法回顾性分析2012年1月至2020年11月显微手术治疗的13例枕骨大孔区脑膜瘤的临床资料。结果7例脑干腹侧肿瘤采用远外侧入路,5例脑干外侧肿瘤采用后正中入路2例、远外侧入路3例,1例脑干背侧肿瘤采用后正中入路。肿瘤全切除12例(Simpson分级Ⅰ级1例,Ⅱ级11例),部分切除1例(Simpson分级Ⅳ级)。3脑干腹侧肿瘤术后出现并发症,其中1例后组颅神经功能障碍、1例肢体肌力下降,治疗半年恢复正常;1例因脑脊液漏,引发颅内感染、肺部感染、尿路感染以及应激性溃疡而死亡。存活12例术后随访18~120个月,平均(77.31±38.25)个月;1例脑干外侧肿瘤出现脑积水,1例复发,其余10例无复发、正常生活。结论对枕骨大孔区脑膜瘤,根据肿瘤位置及特点选择合适的手术入路,术中保护好椎动脉、脑干、后组颅神经等重要组织,显微手术可取得良好的疗效。
Objective To investigate the surgical techniques and outcomes of foramen magnum meningiomas.Methods The clinical data of 13 patients with foramen magnum meningioma who underwent surgery from January 2012 to November 2020 were analyzed retrospectively.Results Far lateral approach was used in 7 patients with ventral foramen magnum meningioma and 3 patients with lateral foramen magnum meningioma.Posterior median approach was used in 2 patients with lateral foramen magnum meningioma and 1 with dorsal foramen magnum meningioma.Total resection of the tumor was achieved in 12 patients(including Simpson gradeⅠin 1 patient and gradeⅡin 11 patients)and partial resection in 1(Simpson gradeⅣ).Postoperative complications occurred in 3 patients with ventral foramen magnum meningioma,including 1 patient with cranial nerve injury,1 with limb weakness and 1 death due to intracranial infection,lung infection,urinary tract infection and stress ulcer.The follow-up of 12 surviving patients ranged from 18months to 120 months,with an average of(77.31±38.25)months.Hydrocephalus occurred in 1 patient with lateral foramen magnum meningioma.One patient had a recurrence,and the other 10 patients had no recurrence and lived normally.Conclusions For the foramen magnum meningiomas,microsurgical resection can achieve good outcomes when the appropriate surgical approaches are selected according to the location and characteristics of the tumors,and the important tissues such as the vertebral artery,brain stem,and cranial nerves are protected during the operation.
作者
邹宇辉
战俣飞
姚书敬
白红民
李天栋
ZOU Yu-hui;ZHAN Yu-fei;YAO Shu-jing;BAI Hong-min;LI Tian-dong(Department of Neurosurgery,General Hospital of Southern Theatre Command,Guangzhou 510010,China)
出处
《中国临床神经外科杂志》
2022年第12期964-966,共3页
Chinese Journal of Clinical Neurosurgery
基金
国家自然科学基金(81302201)。
关键词
脑膜瘤
枕骨大孔区
显微手术
疗效
Foramen magnum meningiomas
Microsurgery
Outcomes
