CAJ | 학술논문

目的探讨侧脑室内肿瘤的临床特点及显微手术方式,旨在提高对该疾病的认识及手术疗效.方法 65例侧脑室内肿瘤,男39例,女26例,首发症状主要是头痛、呕吐(48例);分别经皮层-脑室前入路(34例)、皮层-脑室后入路(20例)和胼胝体前部入路(11例)采用显微外科技术切除;回顾分析其临床特点、手术方式、病理诊断及术后并发症.结果手术全切54例,大部分切除11例.术后病理诊断以室管膜瘤及星形细胞瘤最常见.术后并发症:术后发热26例;术后脑积水9例;脑室内积血或血肿形成7例,其中2例因出现意识障碍后行开颅血肿清除术;术后癫痫7例;术后出现意识障碍4例,均治疗后好转;伤口感染3例.手术死亡3例,其中2例系继发术后癫痫出现呼吸衰竭死亡.结论早期发现侧脑室内肿瘤、周密的手术方案和精细的显微操作以及正确的术后处理是提高显微手术治疗侧脑室内肿瘤全切率、减少术后并发症和死亡率的关键.
목적 탐토측뇌실내종류적림상특점급현미수술방식,지재제고대해질병적인식급수술료효.방법 65례측뇌실내종류,남39례,녀26례,수발증상주요시두통、구토(48례);분별경피층-뇌실전입로(34례)、피층-뇌실후입로(20례)화변지체전부입로(11례)채용현미외과기술절제;회고분석기림상특점、수술방식、병리진단급술후병발증.결과 수술전절54례,대부분절제11례.술후병리진단이실관막류급성형세포류최상견.술후병발증:술후발열26례;술후뇌적수9례;뇌실내적혈혹혈종형성7례,기중2례인출현의식장애후행개로혈종청제술;술후전간7례;술후출현의식장애4례,균치료후호전;상구감염3례.수술사망3례,기중2례계계발술후전간출현호흡쇠갈사망.결론 조기발현측뇌실내종류、주밀적수술방안화정세적현미조작이급정학적술후처리시제고현미수술치료측뇌실내종류전절솔、감소술후병발증화사망솔적관건.
Objective To investigate the clinical characteristics,minimal invasive operation technique and perioperative management of lateral ventrieular tumors.Methods The clinical characteristics,image diagnosis,surgical approaches and postoperative management and surgical outcomes of 65 consecutive cases of lateral ventricular tumors were retrospectively analyzed.Results In our series,total resection was achieved in 54 cases,and subtotal resection was achieved in 11 cases.Lateral ventricular tumors were mostly found in male and in the left side.Headache caused by increased intracranial pressure was the most common clinical symptom.Ependymocytoma and astrocytic glioma are the most common pathologic diagnosis.Postoperative complications included fever (26 cases),hydrocephalus (9 cases),intraventricular hematoma (7 cases) of which 2 cases were evacuated by craniotomy,epilepsy (7 cases),wound infection (3 cases).Postoperative death was happened in 3 cases.Two of them died of respiratory failure due to postoperative epilepsy.Conclusion Early discovery of lateral ventricle tumors,meticulous operation,subtle micromanipulation and right postoperative treatment are the criticality to improve the rate of total resection of lateral ventricle tumors through microsurgical treatment and reduce postoperative complications and mortality.