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目的 探讨鞍结节脑膜瘤手术治疗的入路选择及术中注意要点。方法 选择54例鞍结节脑膜瘤 ,根据肿瘤的直径 (以 3cm为界 )和其发展的方向分别采用单侧额下入路、双侧额下入路与翼点入路进行手术治疗。结果 2 2例单侧额下入路组肿瘤全切除率为83% ;2 6例双侧额下入路组全切除率 77% ,双侧嗅神经损伤 1例 ,因下丘脑损伤死亡 1例 ;6例翼点入路组全切除率 67% ,1例因颈动脉损伤而死亡。结论 应根据肿瘤的大小而选择相应的手术入路 ,依术中情况行整块或囊内切除、部分或全部切除 ,注意保护肿瘤周围的神经与血管。
Objective To investigate the surgical approach to the treatment of sella nodular meningioma and its main points of attention. Methods Fifty - four patients with saddle nodular meningiomas were selected. One - side inferior frontal approach, bilateral inferior frontal approach and pterional approach were selected according to the diameter of tumor (defined as 3 cm) and the direction of its development. Results The complete resection rate was 83% in 22 cases of unilateral inferior frontal access. The total resection rate was 77% in 26 cases of bilateral inferior frontal approach, 1 case of bilateral olfactory nerve injury, 1 case of hypothalamic injury ; 6 cases of pterional approach group total resection rate of 67%, 1 case died of carotid artery injury. Conclusions The corresponding surgical approach should be selected according to the size of the tumor. According to the intraoperative conditions, the procedure should be performed in whole or intracapsular excision, partial or complete resection, and attention should be paid to protect the nerves and blood vessels around the tumor.