根治性切除成人颅咽管瘤的显微外科技术(附69例分析)  

Microsurgical techniques of radical excision for craniopharyngioma in adults:report of 69 cases

作　　者：齐巍[1] 张懋植[1] 张伟[1] 王磊[1] 马康平[1] 赵尚峰[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科,北京100050

出　　处：《中国微侵袭神经外科杂志》2006年第1期6-8,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：北京市科委资助项目(9555101600)

摘　　要：目的总结根治性切除成人颅咽管瘤的显微神经外科手术技巧和临床效果。方法对采用显微神经外科技术治疗的69例原发成人颅咽管瘤病例进行回顾性分析。肿瘤最大径1.5￣6.0cm,平均3.6cm。术前根据肿瘤的性状、大小及部位选择适当的手术入路;术中仔细辨别肿瘤与下丘脑-垂体、视路以及颈内动脉系统的关系,并进行细致的分离,同时注意对穿通动脉的保护。结果手术全切除59例(85.5%),近全切除10例(14.5%)。术后发生尿崩症44例(63.8%),视力、视野障碍3例,无手术死亡。术后平均随访41个月,无肿瘤复发。结论根治性切除成人颅咽管瘤可获得满意的肿瘤控制。Objective To summarize the microsurgical techniques and clinical efficacy of radical excision for craniopharyngioma in adults. Methods Sixty-nine patients with primary craniopharyngioma treated by microsurgical techniques were analyzed retrospectively. The diameter of lesions ranged from 1.5 cm to 6.0 cm with an average of 3.6 cm. Appropriate surgical approaches were selected preoperatively according to tumor properties, sizes and locations. The relations of the tumors to the hypothalamic-pituitary, visual pathway and internal carotid artery systems were attentively identified and the tumor was carefully dissected with protection of the perforators. Results Total removal was achieved in 59 patients （85.5%） and subtotal in 10 （14.5%）. The postoperative diabetes insipidus occurred in 44 cases （63.8%）, and visual acuity and field-of-view dysfunction in 3. There was no surgical mortality. The mean follow-up was 41 months with no recurrence, Conclusion Radical excision for craniopharyngioma in adults can achieve satisfactory and stable tumor control.

关 键 词：颅咽管瘤 神经外科手术 尿崩症 

分 类 号：R739.41[医药卫生—肿瘤]