手术切除松果体区肿瘤时对合并脑积水的处理及预后  

Treatment of hydrocephalus in removal of pineal tumors and its prognosis

作　　者：熊南翔[1] 赵洪洋[1] 王少兵[2] 张光璞[2] 刘正平[2] 朱贤立[1] 李龄[3] 

机构地区：[1]华中科技大学同济医学院附属协和医院神经外科,湖北武汉430022 [2]湖北省新华医院神经外科,湖北武汉430015 [3]华中科技大学同济医学院附属同济医院神经外科,湖北武汉430030

出　　处：《中国微侵袭神经外科杂志》2005年第8期353-354,共2页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨手术切除松果体区肿瘤时对合并脑积水的处理。方法回顾性分析45例松果体区肿瘤合并脑积水病人的手术治疗,归纳经Poppen入路和经Krause入路切除肿瘤时对脑积水的处理办法。术后随访1￣10年,观察脑积水的转归情况。30例病人术前行脑室外引流术。病人均在切除肿瘤时行第三脑室脑池造瘘术。结果随访中10例因再发脑积水行脑室-腹腔分流术。统计学分析表明肿瘤不同切除程度者术后需行脑室-腹腔分流术的概率有显著性差异。结论脑积水的转归与肿瘤切除程度密切相关;尽可能切除肿瘤,彻底开放第三脑室与脑池的交通,是术中成功处理脑积水的关键。Objective To explore the effective methods for treating hydrocephalus associated with removal of pineal tumors. Methods Forty-five patients suffered from pineal tumor and associated hydrocephalus were retrospectively analyzed for their surgeries via Poppen＇s or Krause＇s approach and treatment of hydrocephalus, and were followed up for conversion of hydrocephalus in the past 10 years, the prognosis of the treatment was observed by follow-up. Thirty patients received preoperative ventriculostomy. All the 45 patients underwent third ventriculocistemostomy. Results A ventriculoperitoneal shunt was performed in 10 patients for recurrence of hydrocephalus. Statistical analysis showed significant differences in the necessity of postoperative ventriculocistemostomy between the groups with different resectional degrees. Conclusion Elimination of hydrocephalus is associated with tumor resectional degree, and the key to treat hydrocephalus is to remove tumor as much as possible and to open communications between the third ventricle and basal cistern.

关 键 词：松果体瘤 脑积水 脑幸腹膜分流术 POPPEN入路 Krause入路 

分 类 号：R739.4[医药卫生—肿瘤]