中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
11期
72-73,117
,共3页
梁威%殷会咏%朱旭强%闫东明
樑威%慇會詠%硃旭彊%閆東明
량위%은회영%주욱강%염동명
纵裂入路%第三脑室%胼胝体%显微手术入路
縱裂入路%第三腦室%胼胝體%顯微手術入路
종렬입로%제삼뇌실%변지체%현미수술입로
Longitudinal fissure approach%The third ventricle%Callosum%Microsurgical approaches
目的 探讨经纵裂-胼胝体入路切除第三脑室病变的临床应用.方法 回顾性分析20例第三脑室病变患者均行经纵裂-胼胝体入路切除.结果 经胼胝体-穹窿间入路切除第三脑室肿瘤20例,第三脑室前部肿瘤8例,中部10例,后部2例.肿瘤全切17例,次全切除2例,大部分切除1例.术后病理示:颅咽管瘤6例,胶样囊肿4例,生殖细胞瘤2例,星形细胞瘤2例,垂体腺瘤2例,室管膜瘤2例,脑膜瘤1例,畸胎瘤1例.术后出现多尿、多饮、电解质紊乱6例,中枢性高热5例,经处理后1~2周好转出院;短期内记忆力障碍4例,3个月内均有所恢复;缄默症2例,1个月内恢复;脑积水3例,行脑室-腹腔分流术后恢复良好.结论 经胼胝体-穹窿间入路操作简单,可直视下操作,此入路对周围比较重要的结构及组织损伤小,肿瘤切除率高,患者手术后并发症少、病死率低,是手术切除第三脑室病变的理想入路.
目的 探討經縱裂-胼胝體入路切除第三腦室病變的臨床應用.方法 迴顧性分析20例第三腦室病變患者均行經縱裂-胼胝體入路切除.結果 經胼胝體-穹窿間入路切除第三腦室腫瘤20例,第三腦室前部腫瘤8例,中部10例,後部2例.腫瘤全切17例,次全切除2例,大部分切除1例.術後病理示:顱嚥管瘤6例,膠樣囊腫4例,生殖細胞瘤2例,星形細胞瘤2例,垂體腺瘤2例,室管膜瘤2例,腦膜瘤1例,畸胎瘤1例.術後齣現多尿、多飲、電解質紊亂6例,中樞性高熱5例,經處理後1~2週好轉齣院;短期內記憶力障礙4例,3箇月內均有所恢複;緘默癥2例,1箇月內恢複;腦積水3例,行腦室-腹腔分流術後恢複良好.結論 經胼胝體-穹窿間入路操作簡單,可直視下操作,此入路對週圍比較重要的結構及組織損傷小,腫瘤切除率高,患者手術後併髮癥少、病死率低,是手術切除第三腦室病變的理想入路.
목적 탐토경종렬-변지체입로절제제삼뇌실병변적림상응용.방법 회고성분석20례제삼뇌실병변환자균행경종렬-변지체입로절제.결과 경변지체-궁륭간입로절제제삼뇌실종류20례,제삼뇌실전부종류8례,중부10례,후부2례.종류전절17례,차전절제2례,대부분절제1례.술후병리시:로인관류6례,효양낭종4례,생식세포류2례,성형세포류2례,수체선류2례,실관막류2례,뇌막류1례,기태류1례.술후출현다뇨、다음、전해질문란6례,중추성고열5례,경처리후1~2주호전출원;단기내기억력장애4례,3개월내균유소회복;함묵증2례,1개월내회복;뇌적수3례,행뇌실-복강분류술후회복량호.결론 경변지체-궁륭간입로조작간단,가직시하조작,차입로대주위비교중요적결구급조직손상소,종류절제솔고,환자수술후병발증소、병사솔저,시수술절제제삼뇌실병변적이상입로.
Objective To investigate the clinical application of transcallosal-hemispheres approaches to the third ventricle.Methods Twenty cases of the third ventricle tumors were removed through corpus callosum approach,and the results were analysed.Results Twenty patients with the third ventricle tumors,8 cases being located in the anterior portion of the third ventricle,10 cases in the middle portion and 2 cases in the posterior portion,underwent tumor resection via transcallosal interforniceal approach.Total resection of the third ventricle tumors was achieved in 17 cases,subtotal resection in 2 cases and partial resection in 1 case.The pathological examination revealed 6 craniopharyngiomas,4 colloid cysts,2 germ cell tumors,2 astrocytomas,2 pituitary adenomas,2 ependymocytomas,1 meningioma and 1 teratoma.The postoperative complications included polyuria,polydipsia,electrolyte disorder in 6 patients,central high fever in 5 patients,all of them got improved and discharged after treated for 1 week to 2 weeks;short-term memory disturbance occurred and recovered within 3 months in 4 patients.Mutism appeared and recovered in one month in 2 patients.Three patients had hydrocephalus,all of them underwent ventriculoperitoneal shunt with good recovery.Conclusions The transcallosal-interforniceal approach permitted surgery directly,and the paired vital structures could be viewed clearly and they couldn' t be easily damaged,and the whole third ventricle could be adequately revealed.The approach is safe and direct,has the high resection rate,low postoperative complications and minimal mortality,so it is an ideal choice for the resection of third ventricle tumor.