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目的探讨显微神经外科手术切除加术后伽玛刀联合治疗窦汇区脑膜瘤的有效性。方法回顾性分析2006-2011年15例经手术及病理证实的窦汇区脑膜瘤患者的临床资料。依据肿瘤基底附着部位和主体生长方向选择不同的手术入路,分别采用经枕下幕上入路、经幕上下联合入路及经幕下小脑上入路。结果 15例窦汇区脑膜瘤患者手术达SimpsonⅠ级切除者1例;手术达SimpsonⅡ级切除者2例;SimpsonⅢ～Ⅳ级切除者12例。所有患者手术顺利,术后恢复良好,无死亡病例。术后对未达SimpsonⅠ～Ⅱ级切除的12例患者行伽玛刀联合治疗,术后随访1～5年,无死亡病例,未见肿瘤复发。结论窦汇区脑膜瘤术后有残余肿瘤的患者联合伽玛刀治疗可有效降低窦汇区脑膜瘤术后复发率。
Objective To investigate the effectiveness of microsurgical surgical resection combined with gamma knife surgery in treatment of sinusoidal meningioma. Methods The clinical data of 15 patients with sinus meningioma confirmed by surgery and pathology from 2006 to 2011 were analyzed retrospectively. According to the tumor base attachment site and the main growth direction of the choice of different surgical approaches, respectively, through the occipital transimpedance approach, the supratentorial joint approach and the supratentorial cerebellum approach. Results One case of Simpson Ⅰ resection was operated on in 15 cases of sinus meningiomas. Two cases were performed Simpson Ⅱ level resection and 12 cases of Simpson Ⅲ ~ Ⅳ resection. All patients underwent a successful operation with good postoperative recovery and no deaths. Twelve patients who underwent Simpson Ⅰ ~ Ⅱ resection were treated with Gamma Knife. The patients were followed up for 1 to 5 years without any death and no tumor recurrence was found. Conclusion Douhui meningioma residual tumor surgery patients with gamma knife treatment can effectively reduce the recurrence rate of sinus area after meningioma.