中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2013年
4期
409-411
,共3页
蝶鞍区%肿瘤%手术入路
蝶鞍區%腫瘤%手術入路
접안구%종류%수술입로
Sellar region%Tumor%Operation approach
目的 探讨和评估大型鞍区肿瘤不同手术入路的疗效. 方法 福建医科大学附属漳州市医院神经外科和上海同济大学附属仁济医院神经外科自2004年1月至2012年1月采用不同的手术入路治疗鞍区大型肿瘤患者82例,其中双额底内侧入路32例,单鼻孔经蝶入路32例,扩大的翼点入路12例、单侧额下外侧入路6例,评估不同入路的结果和预后. 结果 本组肿瘤全切除66例,次全切除16例,其中经双额底内侧入路肿瘤全切除28例(87.5％),次全切4例；单鼻孔经蝶经入路肿瘤全切除26例(81.2％),次全切6例；扩大的翼点入路肿瘤全切除9例(75％),次全切3例；单侧额下外侧入路肿瘤全切除3例(50％),次全切3例.无手术死亡患者. 结论 鞍区大型肿瘤的切除可根据肿瘤类型选用经扩大的翼点入路或双额底内侧入路,单鼻孔经蝶入路主要适用于垂体腺瘤.
目的 探討和評估大型鞍區腫瘤不同手術入路的療效. 方法 福建醫科大學附屬漳州市醫院神經外科和上海同濟大學附屬仁濟醫院神經外科自2004年1月至2012年1月採用不同的手術入路治療鞍區大型腫瘤患者82例,其中雙額底內側入路32例,單鼻孔經蝶入路32例,擴大的翼點入路12例、單側額下外側入路6例,評估不同入路的結果和預後. 結果 本組腫瘤全切除66例,次全切除16例,其中經雙額底內側入路腫瘤全切除28例(87.5％),次全切4例；單鼻孔經蝶經入路腫瘤全切除26例(81.2％),次全切6例；擴大的翼點入路腫瘤全切除9例(75％),次全切3例；單側額下外側入路腫瘤全切除3例(50％),次全切3例.無手術死亡患者. 結論 鞍區大型腫瘤的切除可根據腫瘤類型選用經擴大的翼點入路或雙額底內側入路,單鼻孔經蝶入路主要適用于垂體腺瘤.
목적 탐토화평고대형안구종류불동수술입로적료효. 방법 복건의과대학부속장주시의원신경외과화상해동제대학부속인제의원신경외과자2004년1월지2012년1월채용불동적수술입로치료안구대형종류환자82례,기중쌍액저내측입로32례,단비공경접입로32례,확대적익점입로12례、단측액하외측입로6례,평고불동입로적결과화예후. 결과 본조종류전절제66례,차전절제16례,기중경쌍액저내측입로종류전절제28례(87.5％),차전절4례；단비공경접경입로종류전절제26례(81.2％),차전절6례；확대적익점입로종류전절제9례(75％),차전절3례；단측액하외측입로종류전절제3례(50％),차전절3례.무수술사망환자. 결론 안구대형종류적절제가근거종류류형선용경확대적익점입로혹쌍액저내측입로,단비공경접입로주요괄용우수체선류.
Objective To investigate and assess the efficacy of different operation approaches in removal of large tumors in the sellar region.Methods Eighty-two patients with large tumors in the sellar region,admitted to and performed operation via four approaches in our hospital from January 2004 to January 2012,were chosen in our study; 32 of them chose bifrontal basal interhemispheric approach,32 single nostril transsphenoidal approach,12 expanded pterional approach and 6 unilateral subffontal anterolateral approach.The results and prognoses of different operation approaches for different types of tumors were compared.Results Total resection of the tumors was achieved in 66 patients and subtotal resection in 16 patients.Total resection and subtotal resection of the tumors via bifrontal basal interhemispheric approach were achieved in 28 patients (87.5％) and 4 patients,respectively; total resection and subtotal resection of the tumors via single nostril transsphenoidal approach were achieved in 26 patients (81.2％) and 6 patients,respectively; total resection and subtotal resection of the tumors via extended pterlonal approach were achieved in 9 patients (75 ％) and 3 patients,respectively; total resection and subtotal resection of the tumors via unilateral subfrontal anterolateral approach were achieved in 3 patients (50 ％) and 3 patients,respectively.No patients died.Conclusion The removal of large tumor in the sellar region can be operated by the extended pterlonal approach or bifrontal basal interhemlspheric approach according to the type of tumors; single-nostril transsphenoidal approach is mainly applicable to pituitary adenoma.
