目的探讨岩斜区脑膜瘤手术全切影响因素。方法回顾性分析2011年1月—2021年12月于长江航运总医院手术治疗的57例岩斜区脑膜瘤患者的临床资料。采用多因素Logistic回归分析检验岩斜区脑膜瘤全切的影响因素,并分析对比术前术后卡氏功能状态评分(KPS评分)。结果57例患者肿瘤完全切除35例,非完全切除22例,全切率61.40%。多因素Logistic回归分析结果显示,肿瘤质地、直径、肿瘤血供及侵犯海绵窦是岩斜区脑膜瘤全切的独立影响因素(P<0.05)。术前平均KPS评分为83.51,随访平均KPS评分为87.34,脑干受压重患者KPS改善明显(P<0.05)。结论岩斜区脑膜瘤全切术后多数可减少复发,改善功能预后。肿瘤质地、直径、侵袭海绵窦、压迫脑干以及肿瘤被血管神经包绕血运丰富,和手术入路的选择等是影响肿瘤全切除的重要因素。
Objective To explore the influencing factors of total resection for petroclival meningiomas. Methods The clinical data of 57 patients with petroclival meningioma who underwent surgery in Wuhan Brain Hospital from January 2011 to December 2021 were analyzed retrospectively. Multivariate logistic regression analysis was used to test the influencing factors of total resection, and the KPS before and after surgery was compared. Results Among 57 patients, 35 had complete tumor resection and 22 had incomplete tumor resection, with a total resection rate of 61.40%. Multivariate logistic regression analysis showed that tumor texture, diameter, tumor blood supply and invasion of cavernous sinus were independent influencing factors of total resection of petroclival meningioma(P<0.05). The average preoperative KPS score was 83.51, and the average follow-up KPS score was 87.34. KPS improved significantly in patients with severe brain stem compression(P<0.05). Conclusions Total resection of meningiomas in the petroclival region can reduce recurrence and improve functional prognosis. Tumor texture, size, invasion of the cavernous sinus, compression of the brain stem,abundant blood supply of the tumor surrounded by blood vessels and nerves, and the choice of surgical approaches are important factors affecting total tumor resection.