目的总结近 6年来鞍上脑膜瘤 2 2例的手术治疗经验。方法把肿瘤按起源部位、大小和生长方向进行分类 ,手术经翼点入路 10例 ,经双额和右额各 5例 ,右额翼点联合入路 2例 ,颅底重建 1例 ,显微手术 13例。结果肿瘤全切除 18例 ,大部分切除 4例。死亡 1例 ,脑内血肿 2例 ,脑积水 2例 ,侧脑室出血 1例。随访 17例 ,其中 12例优 ,3例良 ,1例一般 ,1例差 ;视力改善 13例 ,稳定 3例 ,恶化 1例。结论显微手术提高肿瘤全切除率和视力改善率 ,颅内外沟通型肿瘤须行颅底重建。手术疗效取决于视神经、下丘脑、垂体柄和脑底动脉的保护 Objective To summarize the surgical treatment experience of 22 cases of suprasellar meningiomas in recent 6 years. Methods The tumor was classified according to the origin, size and growth direction. Ten cases were treated by pterional approach. Five cases were treated with patellar and right forebrain. Two cases were treated with right forehead and two cases with skull base reconstruction. Micro-surgery in 13 cases. Results Tumor resection in 18 cases, the majority of resection in 4 cases. 1 case of death, 2 cases of intracerebral hematoma, 2 cases of hydrocephalus and 1 case of lateral ventricle hemorrhage. Seventeen patients were followed up, of which 12 were excellent, 3 were good, 1 was fair and 1 was poor; 13 were improved visual acuity, 3 were stable, and 1 was worse. Conclusions Microsurgery can improve the total resection rate and visual acuity improvement rate. Skull base reconstruction should be performed in the intracranial and extracranial tumors. Surgical efficacy depends on the optic nerve, hypothalamus, pituitary stalk and cerebral artery protection