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目的探讨运动区附近大型脑膜瘤的大小与预后的关系及显微外科治疗方法。方法选择2005年1月-2010年1月在新疆喀什地区第一人民医院神经外科进行显微手术治疗的10例运动区附近大型脑膜瘤患者的临床资料进行回顾性分析,并对运动区附近大型脑膜瘤的大小与预后的关系、术中神经功能保护及术后神经功能康复进行总结。结果 10例运动区附近大型脑膜瘤患者按Simpson分级,Ⅰ级8例,Ⅱ级2例;全切率(包括按Simpson分级的Ⅰ、Ⅱ级)大脑凸面为100%,矢状窦旁为80%,大脑臁旁为90%。术后出现一侧肢体不同程度偏瘫或原有偏瘫体征加重3例,经脱水、高压氧等治疗,1个月内均有不同程度恢复,完全恢复2例。7例大型脑膜瘤远期生活质量评估(karnofsky performance scale,KPS)5分所占比例为85.7%(6/7),3例巨大型KPS 5分所占比例为66.7%(2/3)。结论对运动区附近大型脑膜瘤采用显微外科技术切除,结合脑膜瘤的大小分型,对临床治疗效果可能更有指导意义,术后对有神经功能损害者早期施行高压氧治疗,可有效提高和改善患者的预后。
Objective To investigate the relationship between the size and prognosis of meningioma in the vicinity of motor area and the microsurgical treatment. Methods From January 2005 to January 2010, the clinical data of 10 cases of meningiomas in the vicinity of motor area were retrospectively analyzed in the Department of Neurosurgery, First People’s Hospital of Kashi, Xinjiang. The relationship between meningioma size and prognosis, intraoperative neurological function and postoperative neurological rehabilitation were summarized. Results Ten patients with meningioma in the motor area were classified according to Simpson grade Ⅰ, grade Ⅱ and grade Ⅱ. The total sagittal rate (including grade Ⅰ and Ⅱ according to Simpson classification) was 100% and the sagittal sinus was 80 %, Next to the brain is 90%. There were 3 cases of hemiplegia on one side or exacerbation of original hemiplegia after operation. After dehydration and hyperbaric oxygenation, all patients recovered within 1 month and recovered completely in 2 cases. Seven cases of large meningioma with karnofsky performance scale (KPS) accounted for 85.7% (6/7), and three cases of giant KPS 5 points accounted for 66.7% (2/3). Conclusion The removal of meningiomas in the vicinity of the motor area by microsurgery combined with the size and type of meningioma may be more instructive in clinical treatment. After the operation, patients with neurological deficits may be treated with hyperbaric oxygen therapy early, which can be effectively improved And improve the patient’s prognosis.