中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2016, Vol. 45 ›› Issue (9): 824–828.doi: 10.12007/j.issn.0258-4646.2016.09.013

• 论著 • 上一篇    下一篇

非颅底位置深在脑膜瘤手术切除的影响因素分析

赵卫华 1,郭再玉 1,许振喜 2,黄楹 3   

  1. 1 天津市泰达医院神经外科,天津 300457;2 天津市第五中心医院神经外科,天津 300450;3 天津市环湖医院神经外科,天津300060
  • 收稿日期:2015-11-10 出版日期:2016-09-28 发布日期:2016-08-29
  • 通讯作者: 黄楹 E-mail:xuzhenxi12@163.com
  • 作者简介:赵卫华(1971 -),男,副主任医师,硕士 .

Influencing Factors of Resection in Non Skull Base Deep-seated Meningiomas

ZHAO Weihua1,GUO Zaiyu1,XU Zhenxi2,HUANG Ying3   

  1. 1 Department of Neurosurgery,Tianjin TEDA Hospital,Tianjin 300457,China;2 Department of Neurosurgery,Tianjin Fifth Central Hospital,Tianjin 300450,China;3 Department of Neurosurgery,Tianjin Huanhu Hospital,Tianjin 300060,China
  • Received:2015-11-10 Online:2016-09-28 Published:2016-08-29

摘要: 目的 探讨非颅底位置深在脑膜瘤手术切除程度的影响因素,为今后评估该类脑膜瘤的治疗提供参考。方法 回顾分 析天津市环湖医院神经外科于 2011 年 1 月至 2015 年 6 月手术治疗的 67 例非颅底位置深在脑膜瘤患者的病历资料。非颅底位 置深在脑膜瘤限定为窦旁(上矢状窦旁脑膜瘤限定为肿瘤基底靠近大脑镰且埋被于皮层下、下矢状窦、直窦)、镰旁、脑室内和 小脑幕脑膜瘤。将 67 例患者的性别、年龄、主诉、病程、既往病史、神经科查体阳性体征、肿瘤部位、大小、形状、增强程度、钙化、 瘤周水肿、神经血管包绕、侵袭性、边界及病理亚型等因素与术中肿瘤是否全切进行单因素分析,筛选出影响肿瘤切除的相关 因素,并对有统计学意义的因素进行二分类 logistic 逐步回归分析,同时记录患者术后并发症及随访情况。结果 肿瘤侵袭性、 瘤周水肿和神经血管包绕是影响肿瘤是否全切的 3 个独立危险因素,其中肿瘤侵袭性是主要因素,肿瘤具有侵袭性不能手术全 切除的危险是不具有侵袭性肿瘤的 9.161 倍。结论 对于非颅底位置深在脑膜瘤,根据肿瘤侵袭性、瘤周水肿和神经血管包绕 情况可以比较客观地评估脑膜瘤切除程度。术前仔细研读患者影像学资料,术中谨慎处理脑膜瘤与周围组织的关系,可有效 提高该类患者的治疗效果。

关键词: 非颅底, 部位, 脑膜瘤, 切除程度

Abstract: Objective To explore the influencing factors of the extent of the surgical resection in non skull base deep-seated meningiomas,so as to provide a reference for the evaluation of the treatment. Methods A total of 67 cases of non skull base deep-seated meningioma in Tianjin Huanhu Hospital from January 2011 to June 2015 were retrospectively analyzed. Non skull base deep-seated meningiomas were limited to para sinus (superior parasagittal meningiomas were limited to the base of the tumor near the falx cerebri and buried in the cortex,inferior sagittal sinus,and straight sinus),falx,intraventricular and tentorium of cerebellum. The patients’general information,clinical features,preoperative imaging information,intraoperative condition and pathologic classification of meningiomas were recorded,univariate analysis(chi-square test or Fisher test ) was performed to screen out the factors related to tumor resection,and factors with statistically significant differences as independent variables were used for binary logistic stepwise regression analysis,at the same time,complication and postoperative follow-up were recorded. Results Tumor invasiveness,peritumoral edema,and vessels and nerves wrap around were three independent risk factors for tumor residual,and tumor invasiveness was the main risk factor,the risk of not complete resection of tumor with invasiveness was 9.161 times of that without invasiveness. Conclusion For non skull base deep-seated meningioma,the extent of the tumor resection can be objectively evaluated by tumor invasiveness,peritumoral edema and vessels and nerves wrap around. Studying imaging of patients carefully before surgery and handling the tissue surrounding meningioma cautiously in operation can effectively improve the curative effect of these patients.

Key words: non skull base, position, meningioma, extent of resection

中图分类号: 

  • R651.1
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