幕上幕下联合入路切除颅内肿瘤28例临床观察  

Intracranial Tumors Removed with Combined Supratentorial and Infratentorial Approach

作　　者：费舟[1] 章翔[1] 王占祥[1] 王西玲[1] 

机构地区：[1]第四军医大学西京医院全军神经外科研究所,西安市710032

出　　处：《中国肿瘤临床》2004年第15期851-853,共3页Chinese Journal of Clinical Oncology

基　　金：教育部高等学校骨干教师资助计划项目资助

摘　　要：目的:对28例应用幕上幕下联合入路肿瘤切除的病例进行回顾研究,以期进一步提高该手术方式的疗效。方法:全组28例,肿瘤均位于小脑幕上下;23例(82.1%)有头痛、头晕等颅内压增高症状;18例(64.3%)出现与听觉有关的症状;13例(46.4%)有小脑损害症状。采用显微外科技术与幕上幕下联合入路切除肿瘤。结果:本组手术全切者22例,大部切除者6例。术后均恢复良好,无死亡。通过信访或门诊随访10个月～10年,24例完全恢复健康,2例生活需要照顾,2例有不同程度恢复。结论:侵及幕上幕下的肿瘤多为良性,以脑膜瘤、神经鞘瘤常见,采用幕上幕下联合入路,在显微镜下分块切除,可最大限度的切除肿瘤,并保护脑重要结构,疗效较好。Objective: A retrospective study has been made on the microsurgical management of 28 cases of intracranial tumors removed with combined supratentorial and infratentorial approach in our hospital between the year 1992 till now in order to increase the clinical outcome of theses diseases. Methods: There are 19 male and 9 female with an age between 5 ~45 years (mean 32.2 years) in this series. All the tumors were located both supratentorially and infratentorially. 23(82.1%) cases had the symptoms of intracranial hypertension. Another 18(64.3%) cases showed malfunction of acoustic organs. Microsurgical techniques and combined supratentorial and infratentorial approaches have been utilized to remove tumors. Results: 22 cases had total removal and others subtotal resection. The postoperative morbidity is zero. The follow-up study in 10 months to 10 years showed that 24 cases resume normal life and 2 cases with dependent life and 2 with recovery to some extent. Conclusions: Tumors with supratentorial and infratentorial extension are normally benign ones such as meningiomas and acoustic neuromas. Microsurgical and piecemeal techniques as well as combined supratentorial and infratentorial approaches may increase the possibility to remove tumors totally and result in improved clinical results.

关 键 词：颅内肿瘤 诊断 手术 

分 类 号：R739.4[医药卫生—肿瘤]