第四脑室肿瘤的诊断和显微手术治疗  

Diagnosis and micro-neurosurgery for the fourth cerebral ventricle tumors

作　　者：胡未伟[1] 郑秀珏[1] 沈罡[1] 刘伟国[1] 沈宏[1] 傅伟明[1] 周景义[1] 

机构地区：[1]浙江大学医学院附属第二医院神经外科,杭州310009

出　　处：《中华肿瘤杂志》2007年第2期144-146,共3页Chinese Journal of Oncology

摘　　要：目的分析第四脑室肿瘤的诊断，探讨显微手术切除颅脑肿瘤的效果。方法86例颅脑肿瘤患者，显微镜下手术切除第四脑室肿瘤，其中全切62例，次全切19例，大部切除5例。术后有39例患者行放射治疗。结果86例患者中，3例术后10d内死亡；83例生存，且症状均有缓解，平均生存期＞3年。术后病理诊断髓母细胞瘤32例，室管膜瘤23例，星型胶质细胞瘤15例，血管母细胞瘤10例，脉络丛乳头状瘤2例，表皮样囊肿4例。结论对髓母细胞瘤、星型胶质细胞瘤、血管母细胞瘤应尽可能做到全切，室管膜瘤与脑干粘连紧密者，可考虑次全切除。颅脑恶性肿瘤患者，应结合放疗等综合治疗。Objective To investigate the diagnostic method and analyze the result of microneurosurgical treatment for tumors of the fourth cerebral ventricle. Methods Tumor of the fourth ventricle was clinically diagnosed in 86 patients basing on the preliminary assessment of symptom and CT or MRI findings. Of these 86 patients treated with micro-neurosurgery, the tumors in 62 were totally removed, subtotally in 19, and partially in 5. Forty-two patients received postoperative radiotherapy. Results Three patients died postoperatively within ten days, and symptoms in 83 were improved after treatment. The average survival period was over 3 years. The pathology included 32 modulloblastomas, 23 ependymoma, 15 astrocytoma, 10 bemangiblastomas, 2 choroid plexus papillomas, and 4 epidermoid cysts. Conclusion Modulloblastoma, astrocytoma and hemangiblastoma are suggested to be removed totally whenever technically possible according to the site, character and volume of the tumor. For ependymoma, if close to the brain stem, is recommended to be subtotally removed. Postoperative radiotherapy may be beneficial for malignant types.

关 键 词：第四脑室肿瘤 显微手术 手术治疗 诊断 

分 类 号：R686[医药卫生—骨科学]