中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2008年
9期
676-678
,共3页
松果体瘤%手术后并发症%幕下小脑上入路
鬆果體瘤%手術後併髮癥%幕下小腦上入路
송과체류%수술후병발증%막하소뇌상입로
Pinealoma%Postoperative complications%Infratentorial supracerebellar approach
目的 评估幕下小脑上入路切除松果体区肿瘤的优点和缺点.方法 回顾性分析53例用该种手术入路所切除肿瘤的临床表现、手术方法 、肿瘤全切程度和术后并发症等.结果 28例显微镜下全切,15例大部切除,8例部分切除,2例活检.术后所有患者均出现不同程度的气颅,但在3-5d后消失.术后38例患者出现眼球上视和会聚功能受限,均在术后2周内恢复.4例出现进行性加重脑积水需行脑室-腹腔分流术.2例患者术后肿瘤残腔出血,虽经积极手术治疗仍死亡.结论 幕下小脑上入路能克服经枕穿幕入路牵拉枕叶、切开小脑幕的缺点,术中解削定位清晰,但暴露范围有限,不适于肿瘤向幕上或偏侧生长者.
目的 評估幕下小腦上入路切除鬆果體區腫瘤的優點和缺點.方法 迴顧性分析53例用該種手術入路所切除腫瘤的臨床錶現、手術方法 、腫瘤全切程度和術後併髮癥等.結果 28例顯微鏡下全切,15例大部切除,8例部分切除,2例活檢.術後所有患者均齣現不同程度的氣顱,但在3-5d後消失.術後38例患者齣現眼毬上視和會聚功能受限,均在術後2週內恢複.4例齣現進行性加重腦積水需行腦室-腹腔分流術.2例患者術後腫瘤殘腔齣血,雖經積極手術治療仍死亡.結論 幕下小腦上入路能剋服經枕穿幕入路牽拉枕葉、切開小腦幕的缺點,術中解削定位清晰,但暴露範圍有限,不適于腫瘤嚮幕上或偏側生長者.
목적 평고막하소뇌상입로절제송과체구종류적우점화결점.방법 회고성분석53례용해충수술입로소절제종류적림상표현、수술방법 、종류전절정도화술후병발증등.결과 28례현미경하전절,15례대부절제,8례부분절제,2례활검.술후소유환자균출현불동정도적기로,단재3-5d후소실.술후38례환자출현안구상시화회취공능수한,균재술후2주내회복.4례출현진행성가중뇌적수수행뇌실-복강분류술.2례환자술후종류잔강출혈,수경적겁수술치료잉사망.결론 막하소뇌상입로능극복경침천막입로견랍침협、절개소뇌막적결점,술중해삭정위청석,단폭로범위유한,불괄우종류향막상혹편측생장자.
Objective To estimate the advantage and disadvantage of infratentorial-supracerebellar approach for removal of pinal region tumor.Method 53 cases of pineal region tumor were retrospectivly reviewed including clinical manifestations,operative approach,degree of tumor resected and complication related to approach.Results Of 53 cases,28 cases were totally removed,subtotally removed in 15 cases,partly in 8 cases and biopsy in 2 cases.After operation air presented in supratentorial cavity in all cases,but disappeared among 3-5 days.38 cases showed limited upgaze and convergency which lasts several days to 2 weeks.4 cases needed to be shunted to eliminate developing hydrocephalus.2 cases developed postopertive hemorrhage in the residual mass,and undergone second operation and died.Conclusions Infratentorial supracerebellar approach can avoid retracting occipital lobe and dividing tent,but it is preferable for small and medium size tumors without lateral expansion.
