84例脑中线部位病变显微手术治疗的探讨  

84 cases probe of central line brain disease in microneurosurgery operation treatment

作　　者：韦鹏翔[1] 栾永欣 周玉嘉[1] 孙龙[1] 李玄[1] 门斯烨[1] 

机构地区：[1]北京中医药大学东方医院国家脑病中心神经外科,100078 [2]沈阳军区208医院神经外科

出　　处：《神经疾病与精神卫生》2007年第4期272-274,共3页Journal of Neuroscience and Mental Health

摘　　要：目的探讨脑中线部位病变,如动脉瘤、三脑室肿瘤、垂体瘤、髓母细胞瘤、脑膜瘤的显微手术治疗方法。方法对84例脑中线部位病变的显微外科治疗进行整理、回顾性分析。结果12例前交通动脉瘤、颈内动脉动脉瘤、后交通动脉瘤成功实施显微外科夹闭,无手术死亡;对6例第3脑室前部胶质瘤采用侧脑室前角门氏孔入路切除肿瘤,其中肉眼全切除5例,1例近全切除;对30例巨大垂体瘤采用冠状开颅、额、翼点联合入路切除肿瘤,其中全切除18例、近全切除12例;对20例髓母细胞瘤采用后正中开颅、小脑蚓部入路切除肿瘤,肉眼全切除18例,近全切除2例,无手术死亡;对16例前颅凹底中线脑膜瘤采用额下硬膜内入路,全切除14例,近全切除2例,无手术死亡发生。结论显微神经外科手术是治疗脑中线部位病变的最有效的方法;掌握深厚的基础理论和熟练的显微神经外科技术,选择合理、适当的手术入路,可以清晰显露病变便于操做减少手术负损伤;及时合理的治疗术后并发症是显微手术治疗后的重要环节。Objective To probe treatment way of microneurosurgery operation in central line brain disease, Such as aneurism, tumor of Ⅲ ventricle, pituitary tumor, medulloblastoma and meningioma. Methods 84 cases of central line brain disease in mlcroneurosurgery treatment were straightened out and reviewed. Results 12 cases aneurism of anterior communication artery, internal carotid artery and posterior communication artery were operated successfully by our microneurosurgery. No operation death; 6 cases glloma of anterior Ⅲ ventricle were operated by approach of anterior angle of ventricle to men＇s hole. Total remove 5 cases ,secondly total remove 1cases; 30 cases giant pituitary adenomas were opera- ted in frontal and pterional approach. Total remove 18 cases, secondely total remove 12cases; 20 cases medulloblastoma were operated in cerebellar vermis approach of post opening skull. Total remove 18 cases, secondely total remove 2cases. No operation death; 16 cases meningioma of anterior cranial fossa were operated in subfrontal approach of intru meniges. Total remove 14 cases, Secondely total remove 2 cases. No operation death. Conclusions Microneurosurgery operation is effective method in central line brain disease treatment. The mastery of microneurosurgery technology and theory, the rational selection of operation approach, and the distict exposure of tumor can decrease side effection of operation. Important step of post microneurosurgery is that the side effetion of post operation is treated best in the time.

关 键 词：脑中线部位病变 显微神经外科 治疗 

分 类 号：R651.1[医药卫生—外科学]