颅内巨大脑膜瘤显微手术治疗策略与疗效分析

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【中图分类号】 R739.41 【文献标志码】A 【文章编号】1672-7770（2025）06-0623-07

Abstract： ObjectiveTo evaluate strategies outcomes microsurgical treatment for giant intracranial meningiomas to analyze factors associated with gross total resection.Methods The clinical data patients with giant meningiomas （maximum diameter ⩾70mm ）underwent microsurgical resection at The Affiliated China from November 2O2O March 2O23 were analyzed retrospectively.Univariate multivariate Logistic regresson analysis was performed to identify factors associated with gross total resection. ResultsTumors were mainly located on cerebral convexity，parasagittal/sagittal falx region， skull base.The overall gross total resection rate （Simpson grades ）was 82.35% （28/34）. Six patients failed to achieve gross total resection due to involvement critical vessels.Both tumor location WHO pathological grade were identified as independent predictors gross total resection（ P<0. 05 ）. No new neurological deficits，intracranial hemorrhage，or deaths occurred postoperatively. All typical cases showed favorable functional recovery after individualized microsurgical treatment. ConclusionsMicrosurgery is preferred treatment for giant intracranial meningiomas.Tumor location pathological grade are main factors affecting rate gross total resection. Based on careful preoperative evaluation an individualized surgical approach， intraoperative strategies combining early control tumor base feding arteries meticulous bipolar coagulation for hemostasis，toger with intratumoral debulking piecemeal resection，preservation venous sinuses critical veins， vascular reconstruction when necessary for brain protection，can increase extent safety resection while preserving neurological function improving patient outcomes.

Key words： giant meningioma; microsurgery；gross total resection； risk factor;clinical outcome

脑膜瘤是常见的颅内肿瘤，约占颅内原发性肿瘤的1/3[1]。（剩余11334字）