CAJ | 학술논문

目的对蝶窦内间隔特点及经蝶窦-鞍区肿瘤手术的关系进行探讨.方法分析北京军区总医院附属八一脑科医院自2008年1月至2010年12月收治的107例经单鼻孔-蝶窦-鞍区肿瘤切除术患者的术前蝶窦内间隔资料,并用以指导术中操作.结果本组肿瘤全部切除67例(62.6%),大部切除21例(19.6%),部分切除19例(17.8%).其中47例根据蝶窦间隔的指示,迅速确定肿瘤所在鞍底位置,或保留无关间隔,并根据间隔确认颈内动脉位置,避免损伤;11例存在复杂蝶窦内间隔者,根据影像学提示得以快速判定鞍底与间隔的关系并确定蝶窦内骨质切除范围与方向,顺利完成手术.手术相关并发症:左侧颈内动脉破裂1例,海绵窦破损4例.结论术前仔细判读蝶窦内间隔影像学资料,用以指导经蝶窦-鞍区肿瘤手术操作,可以预防和减少并发症.
목적 대접두내간격특점급경접두-안구종류수술적관계진행탐토.방법 분석북경군구총의원부속팔일뇌과의원자2008년1월지2010년12월수치적107례경단비공-접두-안구종류절제술환자적술전접두내간격자료,병용이지도술중조작.결과 본조종류전부절제67례(62.6%),대부절제21례(19.6%),부분절제19례(17.8%).기중47례근거접두간격적지시,신속학정종류소재안저위치,혹보류무관간격,병근거간격학인경내동맥위치,피면손상;11례존재복잡접두내간격자,근거영상학제시득이쾌속판정안저여간격적관계병학정접두내골질절제범위여방향,순리완성수술.수술상관병발증:좌측경내동맥파렬1례,해면두파손4례.결론 술전자세판독접두내간격영상학자료,용이지도경접두-안구종류수술조작,가이예방화감소병발증.
Objective To study the relationship of sphenoidal intersinus septa with transsphenoidal resection of sellar area tumor. Methods The pre-operative MRI and CT images of the sphenoid intersinus septa and its importance in transsphenoidal resection of sellar area tumor were studied in 107 patients, admitted to our hospital from January 2008 to December 2010. The amounts, locations, anatomic specialties of the septa and its relationships with the floor of selle, the internal carotid artery canals and the tumors were analyzed to guide the operative procedures during the operation. Results Total removal of the tumors in seller region was obtained in 67 patients, subtotal removal in 21 and partial removal in 19. According to the MRI and CT images of the sphenoid intersinus septa, the location of the tumor and the carotid artery in 47 patients were quickly determined; complex sphenoid intersinus septa was noted in 11 patients, and the relation of sellar floor with the septa was quickly determined and the scope and direction of removal were determined too. Rupture of the internal carotid artery occurred in 1 patient, and damages of the cavernous sinuses occurred in 4. Conclusion Careful study of the pre-operative MRI or CT images of the sphenoidal intersinus septa and its relationship with the floor of seller, the internal carotid artery and the tumor will assure the transspenoidal surgery more precisely and safely, and the complication can be efficiently prevented and decreased.