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目的:探讨鞍结节脑膜瘤的临床特点、手术入路及显微手术技巧。方法:回顾性分析2002年1月至2009年12月收治经显微手术治疗的62例鞍结节脑膜瘤患者的临床资料。根据肿瘤大小、主体生长方向、与周围重要结构关系等选择不同的手术入路。其中,51例鞍结节脑膜瘤经翼点入路,6例经额下入路,5例经额下翼点联合入路切除肿瘤。结果:SimpsonⅠ级和SimpsonⅡ级切除肿瘤55/62例(88.7%),SimpsonⅢ级切除7/62例(11.3%),无手术死亡病例。对62例患者进行随访,随访期限4～96个月,平均随访期38.6个月。47/62例(75.8%)恢复正常生活,12/62例(19.4%)可生活自理,3/62例(4.8%)日常生活需他人帮助,随访期间3/62例(4.8%)肿瘤复发,再次行手术治疗。结论:显微手术治疗鞍结节脑膜瘤疗效确切,充分的术前准备和个体化的手术入路及良好的显微外科技巧,可显著提高肿瘤全切率和减少并发症。
Objective: To investigate the clinical features, surgical approaches and microsurgical techniques of saddle nodular meningiomas. Methods: The clinical data of 62 patients with saddle nodular meningioma treated by microsurgery from January 2002 to December 2009 were analyzed retrospectively. According to the size of the tumor, the main growth direction, the relationship with the surrounding important structure, choose a different surgical approach. Among them, 51 cases of saddle nodular meningiomas were pterional approach, 6 were treated by the inferior frontal approach, and 5 were treated by the combined approach of the lower wing point. Results: There were 55/62 (88.7%) resections of Simpson grade I and Simpson grade II tumors, and 7/62 (11.3%) cases of Simpson grade III resection without surgical death. 62 patients were followed up for 4 to 96 months with an average follow-up period of 38.6 months. A total of 47 of 62 (75.8%) patients returned to normal life, 12/62 (19.4%) were able to take care of themselves and 3/62 (4.8% Surgical treatment again. Conclusion: Microsurgical treatment of saddle nodular meningioma is effective, adequate preoperative preparation and individualized surgical approach and good microsurgical skills can significantly improve the rate of tumor resection and reduce complications.