[1]张祎年　黄文彪　潘亚文.鞍区脑膜瘤的显微手术治疗及预后影响因素分析[J].中国临床神经外科杂志,2015,(01):11-14.[doi:10.13798/j.issn.1009-153X.2015.01.004]
　ZHANG Yi-nian,HUANG Wen-biao,PAN Ya-wen..Microsurgery for sellar meningiomas and analysis of factors related to the prognoses[J].,2015,(01):11-14.[doi:10.13798/j.issn.1009-153X.2015.01.004]
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鞍区脑膜瘤的显微手术治疗及预后影响因素分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2015年01期
页码:
11-14
栏目:
论著
出版日期:
2015-01-30

文章信息/Info

Title:
Microsurgery for sellar meningiomas and analysis of factors related to the prognoses
文章编号:
1009-153X（2015）01-0011-04
作者:
张祎年　黄文彪　潘亚文
730030 兰州，兰州大学第二医院神经外科（张祎年、潘亚文）；650011，昆明市第一人民医院神经外科（黄文彪）
通讯作者：潘亚文，E-mail：panyawen666@sohu.com
Author(s):
ZHANG Yi-nian1;  HUANG Wen-biao2;  PAN Ya-wen1.
1. Department of Neurosurgery, Second Hospital, Lanzhou University, Lanzhou 730030, China
; 2. Department of Neurosurgery, First Hospital of Kunming City, Kunming 650011, China
关键词:
脑膜瘤; 鞍区; 显微手术; 预后
Keywords:
Meningiomas;  Sellar region;  Microsurgery;  Quality of life;  Prognosis
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2015.01.004
文献标志码:
A
摘要:
目的 探讨鞍区脑膜瘤的手术方法及影响患者术后生活质量的因素。方法 回顾性分析2007年10月至2012年10月显微手术治疗的44例鞍区脑膜瘤患者的临床资料，所有患者出院后随访3~60月（平均22.8月），术后3个月采用Karnofsky功能状态量表（KPS）评分评估患者生活质量，KPS评分≥80分为优秀，<80分为不优秀；采用Logistic回归分析影响患者术后生活质量的因素。结果 按Simpson分级标准：Ⅰ级5 例，1级22例，Ⅲ级5例，Ⅳ级12例。本组肿瘤全切除（Simpson分级Ⅰ～Ⅲ级）率为72.7%。术后死亡2例。Logistic回归分析显示，影响术后生活质量的因素有术后视力恢复情况、肿瘤与视神经的关系、肿瘤与颈内动脉及其分支的的关系。结论 对鞍区脑膜瘤患者，合适的手术入路、娴熟的显微操作技术、减少和避免对视神经、下丘脑、垂体等重要结构及其穿支血管的直接操作，是预防和减少术后并发症和提高术后生活质量的有效措施。
Abstract:
Objectives To summarize the clinical and imaging features of the sellar meningioma and the selection of surgical approaches, and to analyze factors influencing the postoperative quality of life in the patients with sellar meningiomas. Methods The clinical data of 44 patients with sellar meningiomas who underwent microsurgery from October, 2007 to October, 2012 were analyzed retrospectively, including clinical manifestations, imaging features, operative approaches, postoperative complications and following up data. Multiple Logistic regression analyses were performed to understand the potential factors influencing postoperative quality of the patient’s life. Results Of 44 patients with sellar meningiomas, 5 received Simpson grade Ⅰ resection of the tumors, 22 grade Ⅱ, 5 grade Ⅲ and 12 grade Ⅳ. The Logistic analysis showed that the factors influencing postoperative quality of the patient life included preoperative Karnofsky performance score, postoperative visual outcome, relationship of the tumor with optic nerve and hypophyseal stalk, relationship between internal carotid artery and its branches, and extent of tumor removal. Conclusions Proper operative approaches, sophisticated microsurgical techniques, advanced medical equipment, refined microsurgical instruments and good protection of the structures such as optic nerve, optic chiasma, hypothalamus, hypophysis and their blood supply are the keys to reducing the postoperative complications and improving quality of life in the patients with sellar memingiomas.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目：2013年高等学校博士学科点专项科研基金(20130211120026)；2013年甘肃省卫生行业科研计划管理项目(GWGL2013-31)；2014年兰州市科技计划项目(2014-1-30)
更新日期/Last Update: 2015-01-30