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目的探讨蝶骨嵴内1/3脑膜瘤显微手术治疗情况。方法对11例经显微外科手术治疗蝶骨嵴内1/3脑膜瘤进行回顾性分析。结果11例患者中肿瘤全切除(SimpsonⅠ、Ⅱ)9例,近全切除2例,无手术死亡。术中证实肿瘤基底部主要位于前床突的尖部、根部内、外侧部及周围延伸。术后5例(45%)患者出现脑血管痉挛伴有一过性肢体运动障碍的脑缺血、水肿症状,神经继发损伤症状。结论显微手术切除是蝶骨嵴内1/3脑膜瘤最有效的治疗方法,掌握全面的解剖知识和熟练的手术技巧,选择恰当的手术入路,良好的肿瘤显露、成功的肿瘤切除及术后并发症的及时处理是显微外科治疗的关键。
Objective To investigate the microsurgical treatment of 1/3 meningioma in sphenoid ridge. Methods Retrospective analysis of 11 cases of microsurgical treatment of 1/3 meningioma in sphenoid ridge. Results Of the 11 patients, 9 cases were completely resected (Simpson Ⅰ, Ⅱ) and 2 cases were treated by near total resection without any operative death. Intraoperatively confirmed that the base of the tumor is located in the tip of the anterior prominence, the root, lateral and peripheral extension. Five patients (45%) had cerebral ischemia, edema symptoms and secondary neurological injury symptoms after cerebral vasospasm with transient limb movement disorder. Conclusions Microsurgical resection is the most effective treatment for 1/3 meningioma in the sphenoid ridge. To master the comprehensive anatomic knowledge and skilled surgical techniques, select appropriate surgical approach, good tumor exposure, successful tumor resection and operation The timely treatment of postoperative complications is the key to microsurgical treatment.