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目的:研究鞍旁脑膜瘤显微手术疗效,分析肿瘤复发影响因素。方法:回顾性分析经显微手术治疗的134例鞍旁脑膜瘤临床及病理资料。结果:肿瘤全切除(Simpson Ⅰ级、Ⅱ级)109例(81.3%),随访病例116例,平均随访时间81.6个月,患者平均生活质量评分(KPS)91.9分,其中优秀90例,良好16例。动眼神经功能障碍6例,三叉神经功能障碍7例,癫痫8例,轻偏瘫9例。96例肿瘤全切除患者中复发12例,复发率12.5%。20例未全切除病例中12例(60%)肿瘤不同程度进展。肿瘤侵犯海绵窦复发率明显高于无海绵窦侵犯患者(P=0.043),肿瘤病理级别越高,复发风险越大(P<0.01)。结论:鞍旁脑膜瘤显微手术治疗能获得良好的远期疗效,手术全切除是首选治疗方法,肿瘤侵犯海绵窦术后需要密切随访,非典型脑膜瘤及间变型脑膜瘤复发风险大,建议术后常规放射治疗。
Objective: To study the effect of microsurgery for parasellar meningioma and analyze the influencing factors of tumor recurrence. Methods: A retrospective analysis of microsurgical treatment of 134 cases of parasellar meningioma clinical and pathological data. Results: 109 cases (81.3%) with complete resection of tumor (81.3%) were followed up, the average follow-up time was 81.6 months. The average quality of life score (KPS) was 91.9, of which 90 were excellent and 16 were good example. Oculomotor dysfunction in 6 cases, trigeminal nerve dysfunction in 7 cases, epilepsy in 8 cases, hemiplegia in 9 cases. In 96 cases of total resection of the tumor recurrence in 12 patients, the recurrence rate of 12.5%. In 20 cases of incomplete resection, 12 cases (60%) tumors progressed to different degrees. The recurrence rate of cavernous sinus invasion was significantly higher than that of cavernous sinus invasion (P = 0.043). The higher the pathological grade was, the higher the risk of recurrence was (P <0.01). CONCLUSION: Microsurgical treatment of parasellar meningioma has good long-term curative effect. Total hysterectomy is the first choice of treatment. Tumor invasion of cavernous sinus requires close follow-up. The risk of atypical meningioma and meningioma recurrence is high Postoperative conventional radiotherapy.