非定型锁孔微创手术入路治疗颅内病变  

Treatment of intracranial lesions via non-defined minimally invasive keyhole approaches

作　　者：漆松涛[1] 石小峰[1] 张喜安[1] 陆云涛[1] 彭玉平[1] 许益明[1] 冯文锋[1] 

机构地区：[1]南方医科大学南方医院神经外科,广州510515

出　　处：《中华神经医学杂志》2007年第7期686-689,共4页Chinese Journal of Neuromedicine

基　　金：广东省重点攻关项目(C31204)

摘　　要：目的探讨和评价非定型锁孔微创手术入路在治疗颅内病变中的方法、外科技巧及价值。方法回顾性分析我们3年中33例采用非定型锁孔微创手术入路治疗的患者临床资料,其中脑膜瘤7例,海绵状血管瘤7例,胶质瘤(Ⅰ级)6例,转移瘤5例,脑脓肿3例,炎性肉芽肿3例,脑动静脉畸形2例。结果采用简易CT定位22例,立体定向引导下定位5例,神经导航引导下定位6例。全切除率为93.9%,次全切除率6.1%。2例切口有轻微感染表现,予处理后痊愈。无手术死亡者。结论对合适的病例采用非定型锁孔手术具有微创、美容、手术操作方便和术后恢复快等优点。结合简易CT、立体定向和神经导航引导下定位能达到病变定位准确,使手术操作精确,并发症低,全切除率高。Objective To discuss and evaluate the methods, surgical techniques and value of non-defined minimally invasive keyhole approaches for the treatment of intracranial lesions. Methods The clinical data of 33 cases undergoing non-defined minimally invasive keyhole surgery within the recent three years were retrospectively analyzed. Among these cases, there were 7 cases of meningioma, 7 cases of cavernous hemangioma, 6 cases ofglioma （grade Ⅰ ）, 5 cases of metastatic tumor, 3 cases of brain abscess, 3 cases of inflammatory granuloma and 2 cases of arteriovenous malformation. Results Simple CT localization was applied to 22 cases, stereotactic-guided localization, to 5 cases and neuronavigation-guided localization, to 6 cases; in all cases, the total resection rate was 93.9% and the subtotal resection rate, 6.1%; two cases were slightly infected, but recovered after treatment. No death occurred via the non-defined keyhole surgery. Conclusion For appropriate patients, the non-defined keyhole surgery is minimally invasive, beautifying, timesaving and rapid in postoperative recovery etc. Assisted with simple CT scan and guided by stereotaxy and neuronavigation localization, the lesions can be localized more accurately and the surgery can be performed more precisely, with low incidence of complications and high total resection rate.

关 键 词：非定型 锁孔手术 颅内病变 

分 类 号：R651.11[医药卫生—外科学]