颅咽管肿瘤的手术入路选择及显微手术治疗  

Surgical treatment and select approach of craniopharyngiomas

作　　者：朱成[1] 郭之通 张弋[1] 

机构地区：[1]蚌埠市第三人民医院神经外科,233000 [2]厦门市第三人民医院

出　　处：《安徽医学》2006年第3期191-193,共3页Anhui Medical Journal

摘　　要：目的探讨颅咽管瘤的显微手术入路及方法。方法从1997年1月至2004年10月对27例颅咽管瘤进行了显微外科手术,病人年龄11～60岁,平均年龄38岁,其中男性18例,女性9例,以视力障碍起病23例,尿崩症6例,隐性糖尿病6例,生长发育迟缓4例,头痛20例,闭经4例。术前均行CT和MRI扫描,肿瘤最大直径5cm,实质性12例,囊性变8例,混合性7例,其中肿瘤钙化18例。经翼点入路13例,经额下入路11例,经纵裂胼胝体入路3例。结果肿瘤全切除14例,次全切除12例,部分切除1例。1例术后10天突发蛛网膜下腔出血死亡。26例术后进行了放疗。结论颅咽管瘤手术切除应根据其生长特点来选择手术入路,大多数病人可达到肿瘤的全切除。Objective To investigate the methods and approachs of removal of craniopharyngiomas. Methods Twenty-seven cases of craniopharyngiomas were resected microsurgically in our hospital from January 1997 to May 2004,Patient＇s age ranged from 11 to 60 years （mean,38 years）,There were 18 males and 9 females. Hypopsia in 23 patients,Diabetes insipidus in 6 patients, Hypoevolutismus in 4 patients, Headache in 20 patients, Amenorrhea in 4 patients. CT and MRI image was performed preoperation, the size of the tumor： 5 cm in max diameter. Solid tumour in 12cases, cystic change of tumors in 8 and solid and cystic of tumors in 7 ,Calcifications were found in 18 patients. 13 patients were operated on via pterional craniotomy, 11 patients were operated on via frontobasal approach,3 patients were operated on via transcallosal-hemispheres Approach. Results Total removal of tumor were achieved in 14 patients,and subtotal removal in12 patients,and partial removal in 1 patients, one died 10 days after operation due to paroxysmal subarachnoid hemorrhage. Results of the radiotherapy can be observed in 26 cases. Conclusion Selection of the operation approach should be made on the basis of the tumor growth characteristics.

关 键 词：颅咽管瘤 显微外科 手术入路 

分 类 号：R739.4[医药卫生—肿瘤]