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目的总结小脑幕脑膜瘤的显微外科手术治疗经验。方法回顾分析2003年3月至2008年9月18例经显微外科手术治疗的小脑幕脑膜瘤病人的临床表现、影像学检查、手术记录、病理及术后早期并发症。结果全切除13例(SimpsomⅠ级4例,Ⅱ级9例),占72.2%;近全切除(SimpsomⅢ级)5例,占27.8%;无手术死亡病例。术后并发症4例,主要为脑神经损伤、小脑损伤、脑脊液漏、偏盲、颅内/切口感染。术后随访1~6年,平均4.1年,仅1例手术后2年复发。结论肿瘤基底及肿瘤与神经血管的关系是选择小脑幕脑膜瘤手术入路的重要依据;术中对静脉窦和回流静脉的保护至关重要。如全切肿瘤可能带来重要的神经功能损害,则应考虑残留部分肿瘤。
Objective To summarize the experience of microsurgical treatment of cerebellar meningioma. Methods The clinical manifestations, imaging findings, surgical records, pathology and early postoperative complications of 18 patients with microsurgical meningioma treated by microsurgery from March 2003 to September 2008 were analyzed retrospectively. Results The total resection in 13 cases (Simpsom Ⅰ 4 cases, Ⅱ 9 cases), accounting for 72.2%; nearly total resection (Simpsom Ⅲ) in 5 cases, accounting for 27.8%; no surgical deaths. Postoperative complications in 4 cases, mainly for cranial nerve injury, cerebellar injury, cerebrospinal fluid leakage, hemianopia, intracranial / incision infection. The patients were followed up for 1 to 6 years, an average of 4.1 years, only 1 case 2 years after surgery recurrence. Conclusion The relationship between the tumor base and tumor and neurovascular is an important basis for the choice of surgical approach to the cerebellar meningiomas. Intraoperative protection of sinus and reflux veins is essential. If the whole tumor may lead to important neurological damage, you should consider the residual part of the tumor.