中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2010年
8期
690-692
,共3页
张激扬%李连祥%王连仲%吴安华
張激颺%李連祥%王連仲%吳安華
장격양%리련상%왕련중%오안화
鞍区%肿瘤%神经外科手术%经基底纵裂间入路
鞍區%腫瘤%神經外科手術%經基底縱裂間入路
안구%종류%신경외과수술%경기저종렬간입로
Sellar region%Tumor%Neurosurgical procedures%Transhasal interhemispheric approach
目的 探讨经基底纵裂间入路治疗鞍区肿瘤的效果.方法 对15例鞍区肿瘤患者,采用经基底纵裂间入路,对手术效果进行分析总结.结果 15例患者肿瘤全切,1例颅咽管瘤患者因高渗性缺水,出院后死亡,2例颅咽管瘤患者纠正高渗性缺水后正常出院.1例颅咽管瘤患者术后半年有复发迹象,行γ-刀治疗,其余患者无复发,术后无颅内感染及脑脊液鼻漏发生,术后不影响美观.结论 经基底纵裂间入路,手术视野广泛,向上可以进入第三脑室,向后可显露中脑导水管,向下可进入鞍内,应用范围广,手术效果好.
目的 探討經基底縱裂間入路治療鞍區腫瘤的效果.方法 對15例鞍區腫瘤患者,採用經基底縱裂間入路,對手術效果進行分析總結.結果 15例患者腫瘤全切,1例顱嚥管瘤患者因高滲性缺水,齣院後死亡,2例顱嚥管瘤患者糾正高滲性缺水後正常齣院.1例顱嚥管瘤患者術後半年有複髮跡象,行γ-刀治療,其餘患者無複髮,術後無顱內感染及腦脊液鼻漏髮生,術後不影響美觀.結論 經基底縱裂間入路,手術視野廣汎,嚮上可以進入第三腦室,嚮後可顯露中腦導水管,嚮下可進入鞍內,應用範圍廣,手術效果好.
목적 탐토경기저종렬간입로치료안구종류적효과.방법 대15례안구종류환자,채용경기저종렬간입로,대수술효과진행분석총결.결과 15례환자종류전절,1례로인관류환자인고삼성결수,출원후사망,2례로인관류환자규정고삼성결수후정상출원.1례로인관류환자술후반년유복발적상,행γ-도치료,기여환자무복발,술후무로내감염급뇌척액비루발생,술후불영향미관.결론 경기저종렬간입로,수술시야엄범,향상가이진입제삼뇌실,향후가현로중뇌도수관,향하가진입안내,응용범위엄,수술효과호.
Objective To explore the surgical therapeutic efficacy of tumors in sellar region through transbasal interhemispheric approach. Method Fifteen sellar region tumor cases was treated through transbasal interhemispheric approach from January 2008 to May 2009. These cases included four craniopharyngiomas, four tuberculum sellae meningiomas, three olfactory grave meningiomas, two nofunction pituitary adenomas,one stalk hypophysial abscess and one frontal lobe glioma. The first symptom of ten cases was disturbance of vision or field of vision,four headace,one insipidus. All the fifteen cases underwent head MRI before and after operation. The diameter of the biggest tumor was 5 cm. All the tumors located around sellar region and grew upward. Result Total resection was achieved in all cases. Hyperosmotc dehydration was observed in 3 patients after operation. One craniopharyngioma patient died after leaving hospital because of electrolyte disturbance. Two craniopharyngioma patients leaved hospital normally after the electrolyte disturbance had been corrected. The original symptoms of rest cases were relieved and there was no nervous dysfunction. One craniopharyngioma patient received Gamma knife radiosurgery after operation because of tumor recurrence. There was no recurrence in the rest cases. There was no intracranial infection or cerebrospinal fluid rhinorrhea. The facial outlook wasn't affected. Conclusions Transbasal interhemispheric approach could provide much more surgical visible angle. Through this approach the third ventricle chould be reached ,the midbrain aqueduct chould be revealed backward and sellar region downward and better outcome of surgery chould be achieved.