CAJ | 학술논문

目的探讨改良翼点入路显微手术治疗颅咽管瘤(craniopharyngioma,CP)的临床效果.方法回顾性总结采用改良翼点入路显微手术切除颅咽管瘤41例.术前准备主要是进行激素的替代疗法和癫痫的预防.手术采用改良翼点入路,术后观察患者的神志、血压、出入水量、尿量、尿比重、电解质及CT、MRI等指标,及时防治尿崩症和电解质紊乱等并发症,预防癫痫和激素水平低下.结果手术全切除33例,次全切除5例,部分切除3例,无手术死亡.术后随访2～19个月,可正常参加生活、学习、工作正常者32例,生活需要帮助者9例,次全切除及部分切除的8例中3例于术后6～12个月复发.结论采用改良翼点入路并结合积极有效的围手术期处理可以降低下丘脑损伤的发生率和提高肿瘤的切除率,获得良好的疗效.
목적 탐토개량익점입로현미수술치료로인관류(craniopharyngioma,CP)적림상효과.방법 회고성총결채용개량익점입로현미수술절제로인관류41례.술전준비주요시진행격소적체대요법화전간적예방.수술채용개량익점입로,술후관찰환자적신지、혈압、출입수량、뇨량、뇨비중、전해질급CT、MRI등지표,급시방치뇨붕증화전해질문란등병발증,예방전간화격소수평저하.결과 수술전절제33례,차전절제5례,부분절제3례,무수술사망.술후수방2～19개월,가정상삼가생활、학습、공작정상자32례,생활수요방조자9례,차전절제급부분절제적8례중3례우술후6～12개월복발.결론 채용개량익점입로병결합적겁유효적위수술기처리가이강저하구뇌손상적발생솔화제고종류적절제솔,획득량호적료효.
Objective To study the clinical effect of microsurgical treatment of craniopharyngioma by modified pterional approach.Methods Forty-one patients were carried out a retrospective case study with craniopharyngioma who underwent microsurgieal treatment via modified pterional approach at our department.Preoperative preparation mainly included hormone replacement therapy and prevention of epilepsy.The modified pterional approach was adopted.The patients' clinical indications were monitored postoperatively such as consciousness, blood pressure, in and out quantity of water, urine specific gravity, electrolytes, CT and MRI, and prompt prevention and treatment of the complications including diabetes insipidus and disorder of electrolytes were carried out after the surgery.Meanwhile, measures were taken to prevent postoperative epilepsy and low level of hormone.Results Thrrty-three patients had total craniopharyngioma resection, 5 had subtotal craniopharyngioma resection and 3 had partial craniopharyngioma resection, and all of them survived from the surgery.2 to 19 months postoperative follow-up showed that 32 patients could normally live,study and work, while 9 patients had to be assisted for normal lives.There was a recurrence of the tumor in 3 patients out of 8 patients that had subtotal and partial craniopharyngioma resection within 12 months postoperatively.Conclusion Adopting modified pterional approach plus efficient and effective perioperative management can reduce the damage rate of hypothalamus and improve the total resection rate of the craniopharyngioma, and achieve good results of the treatment.