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目的:探讨窦汇区脑膜瘤的显微手术治疗策略。方法:回顾性分析2011年11月~2015年4月我院显微切除14例窦汇区脑膜患者的临床资料、手术入路、肿瘤切除程度、术后辅助治疗及随访情况。结果:按simpson切除分级标准,Ⅰ级切除5例,Ⅱ级切除4例,Ⅲ级切除4例,Ⅳ级切除1例。术后病理分级,WHOⅠ级13例,WHOⅡ级1例。术后出现硬膜下积液1例,走路不稳、闭目难立1例,剧烈呕吐1例,一侧肢体肌力下降1例。术后随访5~45个月,平均(23.6±12.82)个月,无死亡病例,无肿瘤复发。结论:详细的术前评估、适当的手术入路、术中对静脉窦的处理以及肿瘤切除程度的评估,必要的术后辅助放射治疗,可以降低窦汇区脑膜瘤治疗的风险和复发率。
Objective: To explore the microsurgical treatment of Douhui meningiomas. Methods: The clinical data, surgical approach, degree of tumor resection, postoperative adjuvant therapy and follow-up were retrospectively analyzed in 14 cases of Douhui meningitis in our hospital from November 2011 to April 2015. Results: According to simpson resection grading standards, Ⅰ grade resection in 5 cases, Ⅱ grade resection in 4 cases, Ⅲ grade resection in 4 cases, Ⅳ grade excision in 1 case. Postoperative pathological grading, WHO Ⅰ 13 cases, WHO Ⅱ grade 1 case. Subdural effusion occurred in 1 case, walking instability, blindness in 1 case, severe vomiting in 1 case, one side of the limb muscle strength decreased in 1 case. The patients were followed up for 5 to 45 months with an average of (23.6 ± 12.82) months without any death and no tumor recurrence. CONCLUSIONS: Detailed preoperative assessment, appropriate surgical approach, intraoperative treatment of sinus and tumor resection degree, and the necessary postoperative adjuvant radiotherapy can reduce the risk and recurrence rate of sinusoidal meningioma treatment.