【摘要】：目的：通過(guò)對(duì)小腦幕腦膜瘤的解剖學(xué)特點(diǎn)、流行病學(xué)特點(diǎn)、臨床表現(xiàn)、影像學(xué)檢查、診斷和手術(shù)方案選擇、術(shù)中靜脈竇處理、術(shù)后并發(fā)癥、病理結(jié)果及隨訪等加以分析討論,以期提高小腦幕腦膜瘤的認(rèn)識(shí)、診斷和手術(shù)治療水平。 研究對(duì)象和方法：本文收集了2010年1月～2014年1月期間山東大學(xué)齊魯醫(yī)院收治的62例小腦幕腦膜瘤病例,針對(duì)其診斷與手術(shù)治療進(jìn)行了回顧性分析。本組所有病人均行CT和MRI檢查,17例行MRA檢查,1例行腦血管造影加栓塞術(shù)。 結(jié)果：62例患者中男14例、女48例,平均年齡約為55.35歲,平均病程22.9個(gè)月。首發(fā)的臨床癥狀以頭痛、肢體共濟(jì)失調(diào)、惡心嘔吐和視力視野改變?yōu)橹�。手術(shù)入路根據(jù)患者情況選擇,手術(shù)全切率(SimpsonⅠ級(jí)和Ⅱ級(jí)切除)69.49%,術(shù)后并發(fā)癥以術(shù)后感染和皮下積液為主,未有長(zhǎng)期并發(fā)癥出現(xiàn)。手術(shù)相關(guān)死亡率1.62%。獲得隨訪的32例患者未有復(fù)發(fā)病例。 結(jié)論： 1.小腦幕腦膜瘤的早期無(wú)臨床特異表現(xiàn),早期診斷困難,晚期主要以顱內(nèi)壓增高表現(xiàn)和顱神經(jīng)損害表現(xiàn),診斷以影像學(xué)檢查為主要依據(jù)。 2.術(shù)前建議同時(shí)行CT和MRI以對(duì)比,必要時(shí)行MRA檢查明確靜脈竇受累情況。常規(guī)不推薦腦血管造影檢查,除非術(shù)前需行栓塞治療。 3.術(shù)中靜脈竇應(yīng)仔細(xì)處理,不宜強(qiáng)行切除侵入靜脈竇內(nèi)腫瘤。手術(shù)總體全切率較高,效果滿(mǎn)意,死亡率低,可出現(xiàn)短期或長(zhǎng)期并發(fā)癥。
[Abstract]:Objective: to analyze and discuss the anatomic features, epidemiological features, clinical manifestations, imaging examination, diagnosis and surgical scheme selection, intraoperative venous sinus management, postoperative complications, pathological results and follow-up of tentorial meningiomas. In order to improve the understanding, diagnosis and surgical treatment of tentorial meningioma. Subjects and methods: 62 cases of tentorial meningioma were collected from January 2010 to January 2014 in Qilu Hospital of Shandong University. The diagnosis and surgical treatment of tentorial meningioma were analyzed retrospectively. All the patients were examined by CT and MRI, 17 cases by MRA and 1 case by angiography and embolization. Results: there were 14 males and 48 females with an average age of 55.35 years and a mean course of disease of 22.9 months. The initial clinical symptoms were headache, limb ataxia, nausea and vomiting, and visual field changes. According to the patient's condition, the total resection rate (Simpson 鈪，

本文編號(hào)：2449418