【摘要】 目的 总结蝶骨翼脑膜瘤的诊断、分型及手术治疗的经验和体会。方法 回顾性分析了经显微手术和病理证实的蝶骨翼脑膜瘤81例，其中内侧型43例，外侧型36例，扁平型2例。巨大型7例，大型63例，小型11例。采用改良翼点入路53例；额下翼点联合入路7例；经颧弓翼点入路15例；额颞眶颧入路6例。结果 Simpson Ⅰ级切除45例，Ⅱ级切除17例，Ⅲa级切除9例，Ⅲb级6例，Ⅳa级3例。术后本组患者颅高压、视力下降及眼球突出等临床症状均有不同程度的改善和恢复。术后随访9个月～6年，复发5例，3例行二次手术。结论 充分全面的术前评估，正确选择手术入路，熟练掌握术区显微解剖及显微手术操作，可以提高肿瘤全切率，减少术后并发症，以降低术后致残率和复发率。

    【关键词】 蝶骨翼脑膜瘤；显微手术；回顾分析

    A clinical analysis of 81 cases of meningioma

    LIU Rui-yun,YANG Yu-shan,YAO Xin.

    Department of Neurosurgery,Huanhu Hospital,Tianjin 300060,China

    【Abstract】 Objective To summarize the experience and understanding of sphenoid wing meningioma diagnosis,subtype and surgical treatment. Methods Total 81 cases of sphenoid ridge meningiomas, which had already been proved by microsurgical operation and post-operative pathology including inside type 43 cases,outside type 36 cases,flat type 2 cases,were retrospectively analyzed.(Huge size 7 cases,Large size 63 cases,Small size 11 cases).The operative approach included revised pterional approach 53 cases,combined subfrontal-pterional approach 7 cases,perional approach with zygomatic arch removal 15 cases,pterional approach together with frontal and temporal approach 6 cases.Results Simpson grade Ⅰ remove was 45 cases;grade Ⅱ 12 cases;Ⅲa 9 cases;Ⅲb 6 cases;Ⅳa 3 cases. All symptoms of these group patients had relieved high intra-cranial pressure, vision deterioration and exophthalmos. Post operative follow-up from 9 months to 6 years,5 cases had tumor recurrence and 3 case accepted second operation.Conclusion Thorough preoperative evaluation,adequate operative approach,full understanding of microanatomy as well as microsurgical skill can improve the rate of total resection,decrease complications as well as post operative mortalities and morbidities. ......