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目的探讨鞍结节脑膜瘤的手术入路和治疗策略。方法回顾性分析32例鞍结节脑膜瘤的临床资料,其中经单侧额下入路6例,经额外侧入路9例,经翼点入路8例,经额下-纵裂入路9例。结果肿瘤达SimpsonⅡ级切除26例,SimpsonⅢ级切除6例。失访3例,29例随访3~60个月,平均18.5个月。9例术前激素水平低下者术后均恢复正常。病人恢复正常工作和生活25例,不能独立生活4例。肿瘤复发2例。结论根据肿瘤大小和不同的生长方式选择恰当的手术入路,同时保护好鞍结节周围的重要结构,是获得良好手术效果的保证。
Objective To study the surgical approach and treatment strategy of sella nodular meningiomas. Methods A retrospective analysis of 32 cases of saddle nodular meningioma clinical data, including 6 cases of unilateral inferior frontal approach, the extra lateral approach in 9 cases, via the pterional approach in 8 cases, by the inferior - longitudinal approach 9 cases. Results The tumors reached Simpson level Ⅱ resection in 26 cases, Simpson Ⅲ level resection in 6 cases. 3 cases were lost to follow-up, 29 cases were followed up for 3 to 60 months with an average of 18.5 months. Nine cases of preoperative hormone levels were returned to normal after surgery. The patient returned to normal work and life in 25 cases, can not live alone in 4 cases. Tumor recurrence in 2 cases. Conclusions Choosing the appropriate surgical approach according to tumor size and different growth patterns while protecting the important structures around the saddle nodules is a guarantee of good surgical outcomes.