摘要
目的：根据作者治疗的１０例鞍膈脑膜瘤（ＤＳＭ）的体会并复习有关文献。方法：根据Ｋｉｎｊｏ报告我们也将此类肿瘤分为三种类型：Ａ型：起于鞍膈的上面，肿瘤位于垂体柄的前方；Ｂ型：起于鞍膈的上面，肿瘤位于垂体柄的后方；Ｃ型：起于鞍膈的下面，垂体挤压不可见。结果：每种类型有各自的临床表现，Ａ型表现为一侧视力障碍及视野缺损，极似鞍结节脑膜瘤，亦有肿瘤较大，表现为尿崩者；Ｂ型除引起视力障碍外，还有垂体功能低下；Ｃ型类似无功能垂体腺瘤，除视野缺损外，还有双颞侧偏盲。结论：ＭＲＩ可对ＤＳＭ作出确切的诊断。手术入路：适于Ａ、Ｂ型的ＤＳＭ的肿瘤，采用经额部入路；适于Ｃ型的ＤＳＭ，采用经蝶窦入路。手术结果：１例死亡。
Objcetive: To introduce our experience of 10 patients with DSM and review of literature. Method: On the basis of Kinjo report, We also classify these tumors into three types: TypeA, originating from the upper surface of the diaphragma sellae anterior of the pituitary stalk, Type B, originating from the upper surface of the diaphragma sellae posterior to the pituitary stalk, and Type C, Originating from the inferior surface of the diaphragma sellae. Result: Type A mainly presents with unilateral visual disturbance and visual field defects resembling those of tuberculum sellae meningimas, although preoperative diabetes insipidus occured in patients with large tumors. Type B causes fewer visual disturbances, but more memory distubance and hypopituitarism. Type C closely resembles nonfunctioning pituitary adenomas with bitemporal hemianopsia and hypopituitarism. Conclusion: MRI can accurately diagnose DSM. Surgical approaches include the pterional for type A and B and transsphenoidal for type C. Except one case died of pulmonary embolism, 9 cases got good results.
出处
《中华神经外科杂志》
CSCD
北大核心
1998年第2期78-80,共3页
Chinese Journal of Neurosurgery
