摘要
目的探索手术根治颅咽管瘤的方法。临床资料与手术方法：２３例颅咽管瘤病人年龄１５～５５岁。平均年龄３４．０８岁，以视力障碍起病１２例，月经紊乱或闭经３例，头痛７例，性欲减退１例。ＭＲ检查肿瘤＜２．０ｃｍ者２例，２．１～３ｃｍ者１１例，３．１～４ｃｍ者５例，４．１～５ｃｍ者４例，＞６ｃｍ１例。肿瘤位于鞍上者１４例，进入三脑室内者７例，鞍上和鞍内者２例。肿瘤钙化者１３例，无钙化者１０例；囊性１８例，完全实性５例。二次手术者３例，初次手术２０例。全部病人均在全麻后行右翼点入路，术中根据肿瘤位置，可以从交叉前间隙，颈内动脉和视神经间隙及颈内动脉外侧间隙切除肿瘤。结果：除１例二次手术病人肿瘤近全切除外，２２例肿瘤全切，术后１～６个月观察，术后参加日常工作者２１例，生活需要照顾者１例，１例病人术后７天因误吸窒息死亡。结论：翼点入路是对鞍上和三脑室内各种类型的肿瘤手术切除的优选入路，绝大多数病人可达到肿瘤全切除及良好的愈后。
patientswithcraniopharyngionaswereoperatedthroughpterionalapproach.Patients'agerangedfrom15to55years(mean,34.08year).Maleis14andfemale9.MRimageshowedthesizeofthetumor:<2cmindiameterin2patients,2.1～3.0cmin11,3.1～4.0cmin5,4.1～5.0cmin4,>6cminone.Thetumorslocatedinsupraselarcisternsin14,thetumorsexpandedintothethirdventriclein7.andintraselain2.Calcificationtumortissuewerefoundin13patients,cysticchangeoftumorsin18patientsandsolidtumorin5patients.Twentypatientsunderwentoneop-erationandthreepatientshadsecondoperation.Alpatientswereoperatedviatherightpterionalcran-iotomy.Dissectionwasperformedintheparachiasmalspacesincludingtheprechiasmaticopticocarotid,orcarotidtentorialspaceandlaminaterminals.Thesolidportionofthetumorwasremovedbypiece-meal.Totalremovaloftumorswereachievedin22patients,andsubtotalremovalinonepatient.Alpatientswerefolow-upfrom1to6months,21patientsrecoveredtonormallife,onepatientsneedas-sisted,andonedied7daysafteroperationduetoinhalationasphyxia.Theauthorssuggestpterionalap-proachmaybethebestwayforcompleteremovalofcraniopharyngioma.
出处
《中华神经外科杂志》
CSCD
北大核心
1996年第6期335-335,共1页
Chinese Journal of Neurosurgery
