显微神经外科联合术后伽马刀治疗窦旁脑膜瘤的临床观察

目的 探讨显微神经外科手术联合术后伽马刀治疗窦旁脑膜瘤的疗效和安全性。方法 2008年6月至2013年7月34例窦旁脑膜瘤患者行显微手术切除，术后1～3个月复查头部MRI，对SimpsonⅡ级和Ⅲ级切除者追加伽马刀治疗。结果 34例患者中，Simpson Ⅰ级切除9例，Simpson Ⅱ级切除20例，Simpson Ⅲ级切除5例。术后并发轻瘫9例，无术后脑肿胀、重残和死亡病例。术后对Simpson Ⅱ级和Ⅲ级切除的25例患者进行伽马刀治疗（剂量8～20Gy）。术后随访6～36个月， 3例复发，其中Simpson Ⅱ级1例，Simpson Ⅲ级2例。结论 显微神经外科手术联合术后伽马刀治疗窦旁脑膜瘤安全性较好，复发率低。

Microneurosurgery associated with gamma knife in venous sinuses meningiomas therapy

Objective To investigate the efficacy and safety of microneurosurgery associated with gamma knife on venous si-nuses meningiomas. Methods From June 2008 to July 2013, 34 patients with venous sinus meningiomas were underwent microneuro-surgery. All the patients accepted MRI examination in 1-3 months after operation. Cases of SimpsonⅡandⅢ grade resection received gamma knife therapy to decrease recurrence. Results Among the 34 patients, Simpson I, Ⅱand Ⅲ grade resection was achieved in 9, 20 and 5. Nine cases suffered muscle weakness, and no brain swelling, serious disablity and death occurred. Twenty-five cases of Simpson Ⅱand Ⅲ grade received gamma knife treatment in 1-3 month after operation with total dose of 8-20Gy. The follow-up ranged 3-36 months. One case of Simpson Ⅱ resection and 2 cases of Simpson Ⅲ resection recurred. Conclusion Patinent microsurgical treatment associated with gamma knife in the treatment of venous sinuses meningiomas shows ideal efficacy and low recurrence.