摘要
目的探讨显微手术切除颅咽管瘤的有效方法及术后并发症分析。方法回顾性分析103例颅咽管瘤病人的临床资料。手术均在显微镜下进行,其中采取翼点入路76例,额下入路16例,纵裂胼胝体入路10例,经蝶入路1例。结果 肿瘤全切除65例,次全切除26例,大部分切除12例。术后出现尿崩69例,术后癫疒间7例,中枢性高热5例,动眼神经损伤4例,垂体功能永久性低下3例;术后1月内死亡2例。随访67例,随访时间2个月~11年,平均3.5年。能基本正常学习生活52例,肥胖12例,垂体前叶功能低下3例,死亡6例,复发11例。结论应根据肿瘤的具体性状选择不同的手术入路,翼点入路适用于大部分病例;熟练细致的显微神经外科操作和积极主动的术后管理对降低病人的致残率、致死率及改善病人生活质量有重要意义。
Objective To investigate the microsurgical treatment and analysis of the postoperative complications for craniopharyngiomas.Methods Clinical data of 103 patients with craniopharyngioma undergoing microsurgical resection were analyzed retrospectively.The operation was performed via pterional approach in 76 cases,subfrontal approach in 16,transcallosal approach in 10 and transsphenoidal approach in 1.Results Total tumor removal was achieved in 65 cases,subtotal removal in 26 and partial removal in 12.Postoperatively diabetes insipidus occurred in 69 cases,epilepsy in 7,central high fever in 5,oculomotor nerve injury in 4,permanent hypopituitarism in 3.Two patients died within 1 month after operation.Sixty-seven patients were followed up for mean of 3.5 years,ranged from 2 months to 11 years.Normal work and life enjoyment were found in 52 patients,adiposity in 12,anterior pituitary hypofunction in 3.The tumors recurred in 11 cases and 6 patients died.Conclusions The choice of microsurgical approach for craniopharyngioma resection is based on the location,size and characteristic of the tumor,while pterional approach is appropriate for most patients.Skillful microsurgery,meticulous manipulation,and active management for postoperative complications are very important in reducing the fatality and disability rate and improving life quality.
出处
《中国微侵袭神经外科杂志》
CAS
北大核心
2011年第1期4-7,共4页
Chinese Journal of Minimally Invasive Neurosurgery
