经外侧裂岛叶肿瘤切除术  

Surgical resection of intrinsic insular tumors via transsylvian surgical approach

作　　者：张义[1] 赵卫东[1] 罗青扬[1] 鲍伟民[1] 毛仁铃[1] 黄峰平[1] 

机构地区：[1]复旦大学附属华山医院神经外科,上海200040

出　　处：《中国神经精神疾病杂志》2004年第6期405-407,i008,共4页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的　探讨经外侧裂行显微手术切除岛叶肿瘤的方法。方法　自 2 0 0 2年 7月至 2 0 0 4年 1月 ,采用经外侧裂岛叶肿瘤切除术 2 6例 ,详细记录手术方法 ,术后 3日内复查头颅CT ,跟踪随访术后神经功能状态。结果　 2 6例中肉眼肿瘤全切除 18例 (其中 15例为胶质瘤Ⅱ级 ) ;近全切除 (>80 % ) 6例 ,大部切除 (6 0 %～ 80 % ) 1例 ,活检 1例。术后 19例无明显神经功能障碍。 2 5例随访 2～ 18个月 ,1例胶质瘤Ⅳ级者长期卧床 ,1例海绵状血管瘤伴出血者术后失语明显加重 ,经高压氧康复治疗后好转 ,余 2 3例无明显神经功能障碍 ,生活状态基本同术前。结论　对于岛叶肿瘤 ,尤其是低级别胶质瘤 ,应采用经外侧裂显微手术 ,争取全切除肿瘤 ,保护神经功能。Objective To study the surgical method in resection of intrinsic insular tumors via transsylvian approach. Methods From June 2002 to January 2004, 26 patients with intrinsic tumors of the insula underwent craniotomies via transsylvian approach. The outcome was followed up with the emphasis on the extent of tumor resection and neurological complications. Results According to early postoperative CT imaging, the tumor was completely removed in 18 patients, nearly complete removed (>80%) in 6, incomplete removed(60%～80%) in 1 patient. In the other 1 patient, only biopsy was performed. There was no death related with operation. During the early post operation, 19 patient presented with no neunlogical deficits. Among the 4 patient with pre operative hemiparesis, symptoms of 1 were improved, 1 unchanged and of the other, 2 worsened. At the 3 month follow up examination, only two patients presented severe neurological dysfunction, the neurological conditions either were improved or unchanged in 23 patient. Conclusions Intrinsic insular tumors can be resected safely with microsgical via the transsylvian approach.

关 键 词：经外侧裂人路 岛叶肿瘤 显微手术 

分 类 号：R739.41[医药卫生—肿瘤]