颞下经小脑幕岩骨嵴入路切除岩斜区脑膜瘤的显微外科治疗-论文.pdf

《颞下经小脑幕岩骨嵴入路切除岩斜区脑膜瘤的显微外科治疗-论文.pdf》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。

1、第29卷第4期川北医学院学报Vo1．29．No．42014年8月JOURNALOFN0RTHSICHUANMEDICALCOLLEGEAug-2014367doi：10．3969／j．issn．1005-3697．2014．04．12论著．．．颞下经小脑幕岩骨嵴入路切除岩斜区脑膜瘤的显微外科治疗张涛，唐晓平，彭华，印晓鸿，赵龙，段军伟，段劫(川北医学院附属医院神经外科，四川南充637000)【摘要】目的：探讨显微外科条件下以颞下经小脑幕岩骨嵴入路切除岩斜区脑膜瘤的临床疗效。方法：回顾性分析23例岩斜区脑膜瘤病人的临床资料，手术人路均选择颞下经小脑幕岩骨嵴入路，其中7例联合幕

2、下乙状窦后人路。结果：对术后肿瘤切除程度根据Simpson分级：I～Ⅱ级切除12例；m级切除3例；1v级切除8例。术后出现昏迷2例；面神经功能小于Ⅲ级7例；眼球运动障碍11例；听力障碍2例；肢体肌力下降3例；颅内感染2例；死亡1例。15例随访6～30个月，术前症状及术后并发症大部分不同程度改善，随访期内1O例无肿瘤复发及残余肿瘤进展，5例肿瘤明显复发再次手术。结论：颞下经小脑幕岩骨嵴人路是岩斜区脑膜瘤手术治疗的重要方式，具有暴露满意、手术创伤小的优点。联合幕下乙状窦后人路可进一步增大幕下的暴露范围。对于无法全切的Simpson11级以上肿瘤，术后可辅助刀放射治疗抑制残余肿瘤

3、进展，降低复发率。【关键词】颞下；小脑幕岩骨嵴；岩斜区；乙状窦后；脑膜瘤；显微外科【文章编号】1005—3697(2014)04—0367~4【中图分类号】R739．45【文献标志码】AMicrosurgeryforablatingpetroclivalregionmeningiomasbyinfratempo-ralandtentorail-cristapetrosaapproachZHANGTao，TANGXiao-ping，PENGHua，YINXiao-hong，ZHAOLong，DUANJun—wei，DUANJie(DepartmentofNeurosurger

4、y，AffiliateHospitalofNorthSichuanMedicalCollege，Nanchong637000，Sichuan，China)【Abstract】0bjective：Toexploretheclinicalefectofablatingpetroclivalregionmeningiomasbyinfratemporalandtentorail—cristapetrosaapproachintheconditionofmicrosurgery．Methods：Theclinicaldataof23patientswithpetroclivalre

5、gionmeningiomaswereretrospectivelyanalyzed．Theinfratemporalandtentorail—cristapetrosaapproachwaschosen．Andamongthesepatients，suboccipitalret-rosigmoidapproachwasassociatedin7cases．Results：TheablatingleveloftumorisbasedofSimpsongrade：ItoIIgradeablatedin12cases，mgradeablatedin3casesandIvgrad

6、eablatedin8cases．Aftertheoperation，thereiscomain2cases，facialnervefunctionlessthanⅢgradein7cases，opticalmovementdisorderin11cases，hearingdisturbancein2csase，muscleweaknessin3cases，in—tracranialinfeionin2casesandonepatientdied．15patientshadbeenfollow—upvisitedin6—30months．Inthesepatients，mo

7、stofthepreoperativesymptomsandpostoperativecomplicationshadbeenimproved．Inthefollow—upphase，thetumordoesnotreoccurandrem—nanttumorhasnoadvancedin10cases．Thetumorrecurredobviously，andthenhadbeenoperatedin5cases．Conclusion：Itisanim-portantmethodthatpetroclivalre