摘要
目的:研究比较松果体区肿瘤的显微外科手术切除不同手术入路及其优缺点。方法:回顾分析收治的48例松果体区肿瘤患者的手术情况及术后表现,并进行分析。结果:48例患者中,经枕小脑幕切开(Poppen)入路31例,幕下小脑上(Krause)入路8例,经胼胝体-穹窿间入路6例,经胼胝体后部(Dandy)入路2例,颞部侧脑室三角部入路1例。肿瘤全切除40例,次全切除5例,大部分切除3例。8例未全切者及病理证实为恶性的病变术后行放疗和(或)化疗,5例术后并发脑积水行分流术,偏盲1例,死亡2例,随访6个月～6年,KPS大于80分者约43例。结论:松果体区肿瘤的手术治疗效果较好,全切率高、死亡率低,合理的入路及体位,娴熟的显微外科手术技巧是手术成功的关键,Poppen入路和Krause入路是符合微创理念的理想入路。
Objective：To investigate the effect of different microsurgical treatment approaches on pineal region tumor.Methods：A retrospective study was done on 48 patients with pineal region tumors.The clinical characteristic,surgical approach and prognosis were reviewed.Results：All of the patients were operated via occipital transtentorial approach（n=31）,intratenorial supracerebellar approach（n=8）,trans-frontal-callosal-interfomiceal（n=6）,transcallosal approach（n=2）and transventrical approach（n=1）.Total,subtotal,partical removal the tumors were achieved in 40,5,and 3 cases,respectively.The last 8 patients were treated by radiotherapy and /or chemotherapy after operation because the appearance of their tumor seemed malignant.Five cases received by-pass technique because of hydrocephalus,one case had hemiamaurosis and 2 cases died in postoperative period.Followed up for 6-72 months,and the KPS score was more than 80 in 43 cases.Conclusion：Surgery was an effective treatment for pineal region tumor with suitable approach,position and skilled microsurgical technique played a key role in the treatment of pineal region tumors.Poppen and Krause approaches were the most ideal approach according to the principle of minimal damage done on the pineal region tumors.
出处
《华西医学》
CAS
2008年第1期65-66,共2页
West China Medical Journal
