CAJ | 학술논문

目的：探讨用翼点-前纵裂终板联合入路进行颅咽管瘤全切术治疗中型、大型颅咽管瘤的临床效果。方法：对2011年以来我院收治的21例中型、大型颅咽管瘤患者的临床资料进行回顾性研究。对这21例患者均在显微镜下使用翼点-前纵裂终板联合入路进行颅咽管瘤全切术治疗。术后，观察这些患者的治疗效果。结果：这21例患者经术后病理检查均被确诊患有颅咽管瘤。这21例患者颅咽管瘤的全切除率为80.9%，次全切除率为19.1%。这些患者肿瘤残留的部位主要在脑垂体柄和第三脑室底前部。这些患者术后尿崩症的发生率为76．2％，电解质紊乱的发生率为61.9％。这21例患者的意识均在术后一周内恢复清醒。对这21例患者进行5个月～3年的随访，没有1例患者死亡。结论：用翼点-前纵裂终板联合入路进行颅咽管瘤全切除术治疗中型、大型颅咽管瘤的效果显著。此方法值得在临床上推广使用。
목적：탐토용익점-전종렬종판연합입로진행로인관류전절술치료중형、대형로인관류적림상효과。방법：대2011년이래아원수치적21례중형、대형로인관류환자적림상자료진행회고성연구。대저21례환자균재현미경하사용익점-전종렬종판연합입로진행로인관류전절술치료。술후，관찰저사환자적치료효과。결과：저21례환자경술후병리검사균피학진환유로인관류。저21례환자로인관류적전절제솔위80.9%，차전절제솔위19.1%。저사환자종류잔류적부위주요재뇌수체병화제삼뇌실저전부。저사환자술후뇨붕증적발생솔위76．2％，전해질문란적발생솔위61.9％。저21례환자적의식균재술후일주내회복청성。대저21례환자진행5개월～3년적수방，몰유1례환자사망。결론：용익점-전종렬종판연합입로진행로인관류전절제술치료중형、대형로인관류적효과현저。차방법치득재림상상추엄사용。
Objective To investigate resection operations method and techniques of craniopharyngiomas via the transpterional and trans-lamina terminalis combined approach. Methods:The 21 cases of patients with median/massie craniopharyngiomas were resected via the transpterional and trans-lamina terminalis combined approach in microneurosurgery. The clinical operation effects and postoperative complications were analyzed and summarized through operation video and clinical data. Results: The total resection rate and subtotal removal rate were respectively 80.9% and 19.1% in all the cases group of craniopharyngiomas. residual tumor sites were mainly in the pituitary stalk and/or the front floor of the third ventricle, subtotal resection cases were treated with gamma knife radiotherapy in 4 months after operations. The most commonhypothalamic postoperative complications were diabetes insipidus (76.2%) and electrolyte disturbances (61.9%). These postoperative reactions could be well controlled by medication. No patient died in follow-up period of 5 months-3 years. Conclusions: The median/massie craniopharyngiomas of Samii craniopharyngiomas classification level II - V could treated very well by transpterional and trans-lamina terminalis combined approach. The preoperative imaging analysis of CT/CTA/MR and accurate procedures in microsurgery opera tion are the most important keys for craniopharyngiomas resections.