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目的探讨天幕脑膜瘤的分型和手术入路的选择。方法回顾性分析天幕脑膜瘤87例资料。87例中,采用幕下小脑上入路23例,乙状窦后入路36例,枕部幕上入路21例,幕上下联合入路3例,颞下入路4例。3例血供丰富的巨大脑膜瘤,采用了射频热凝辅助切除。结果肿瘤全切除54例,次全切除31例,大部分切除2例;无一例手术死亡。手术后并发视野障碍6例、脑神经损害3例、偏瘫3例,均经对症治疗后痊愈。结论天幕脑膜瘤的临床表现多不典型,诊断主要依靠MRI和CT。显微手术是治疗该病的最佳方法 。
Objective To explore the classification of the type of meningiomas and the choice of surgical approach. Methods Retrospective analysis of 87 cases of meningioma. In 87 cases, supratentorial cerebellar approach was performed in 23 cases, retrosigmoid approach in 36 cases, occipital supraclavicular approach in 21 cases, supratentorial approach in 3 cases and infratemporal approach in 4 cases. 3 cases of blood supply rich huge meningiomas, the use of RFH adjuvant resection. Results Total resection of tumor in 54 cases, subtotal resection in 31 cases, the majority of resection in 2 cases; no case of surgical death. Postoperative complications of visual field in 6 cases, 3 cases of cranial nerve damage, hemiplegia in 3 cases, were cured after symptomatic treatment. Conclusion The clinical manifestations of meningioma are mostly atypical, and the diagnosis mainly depends on MRI and CT. Microsurgery is the best way to treat the disease.