中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2009年
8期
1375-1376
,共2页
徐声亮%陆四方%林运全%黄雪钦
徐聲亮%陸四方%林運全%黃雪欽
서성량%륙사방%림운전%황설흠
颅咽管瘤%翼点入路%显微手术
顱嚥管瘤%翼點入路%顯微手術
로인관류%익점입로%현미수술
Craniopharyngiomas%Pterion approach%Microsurgery
目的 探讨经翼点入路显微神经外科手术治疗鞍上型颅咽管瘤疗效及安全性.方法 回顾性分析采用经翼点入路显微手术治疗的28例鞍上型颅咽管瘤患者的临床资料.结果 全切除24例(86%),近全切除4例(14%);术后并发症:尿崩症23例(有3例遗留永久性尿崩症),高热16例,血电解质紊乱26例,癫痫8例,意识障碍5例,应激性溃疡3例,垂体功能低下12例.1例术后死于高血钠.随访26例,随访时间12~58个月,能正常生活者22例,生活需要照顾者3例,视力、视野障碍者均有不同程度恢复,全切除病例随访期内未发现复发者.结论 显微外科手术治疗鞍上型颅咽管瘤临床疗效较好,术中注意保护丘脑及各穿支动脉、滋养动脉,是减少术后并发症的关键.
目的 探討經翼點入路顯微神經外科手術治療鞍上型顱嚥管瘤療效及安全性.方法 迴顧性分析採用經翼點入路顯微手術治療的28例鞍上型顱嚥管瘤患者的臨床資料.結果 全切除24例(86%),近全切除4例(14%);術後併髮癥:尿崩癥23例(有3例遺留永久性尿崩癥),高熱16例,血電解質紊亂26例,癲癇8例,意識障礙5例,應激性潰瘍3例,垂體功能低下12例.1例術後死于高血鈉.隨訪26例,隨訪時間12~58箇月,能正常生活者22例,生活需要照顧者3例,視力、視野障礙者均有不同程度恢複,全切除病例隨訪期內未髮現複髮者.結論 顯微外科手術治療鞍上型顱嚥管瘤臨床療效較好,術中註意保護丘腦及各穿支動脈、滋養動脈,是減少術後併髮癥的關鍵.
목적 탐토경익점입로현미신경외과수술치료안상형로인관류료효급안전성.방법 회고성분석채용경익점입로현미수술치료적28례안상형로인관류환자적림상자료.결과 전절제24례(86%),근전절제4례(14%);술후병발증:뇨붕증23례(유3례유류영구성뇨붕증),고열16례,혈전해질문란26례,전간8례,의식장애5례,응격성궤양3례,수체공능저하12례.1례술후사우고혈납.수방26례,수방시간12~58개월,능정상생활자22례,생활수요조고자3례,시력、시야장애자균유불동정도회복,전절제병례수방기내미발현복발자.결론 현미외과수술치료안상형로인관류림상료효교호,술중주의보호구뇌급각천지동맥、자양동맥,시감소술후병발증적관건.
Objective To explore the microsurgical techniques for total removal of the suprasellar cranio pharyngiomas via the pterional approach.Methods The clinical data of 28 patients with suprasellar craniopharyngio mas resected by the microsurgery was analyzed retrospectively.Results The tumors were total removed in 24 cases (86%)and subtotal resected in 4 cases(14%).The frequent postoperative complications are diabetes insipidus,hy perthermy,imbalance of water and electrolyte and lower level of hormone.Conclusion It is the key to get fine operation effect that removal sclerotin of base of skull as far as possible and releasing cerebrospinal fluid sufficiently,paying attention to protect the perforating branch and nourishing artery in each operative spaces.