儿童第三脑室后部肿瘤手术入路的选择  

Selection of the surgical approach to tumors of posterior third ventricle in children

作　　者：邢俭[1] 岳颖[1] 杨庆哲[1] 任铭[1] 

机构地区：[1]北京三博脑科医院小儿神经外科,100093

出　　处：《中华神经外科杂志》2010年第2期142-144,共3页Chinese Journal of Neurosurgery

摘　　要：目的探讨儿童第三脑事后部肿瘤手术入路。方法观察21例儿童第三脑室后部肿瘤神经影像的表现，根据肿瘤的生长方向，以中脑顶盖部为标志点，肿瘤主体2／3位于中脑顶盖部前者采用右额顶开颅经胼胝体-穹隆间入路，肿瘤主体2／3位于中脑顶盖部后者采用枕部经小脑幕入路（Poppen入路）。结果肿瘤全切18例，近全切除3例，无昏迷，无瘫痪，无死亡。结论根据第三脑室后部肿瘤生长方向的不同，以中脑顶盖部为标志点，合理选择手术入路，可以最大程度地发挥各种手术入路的优势，尽可能多地切除肿瘤，最大限度地保护正常脑组织结构，减少手术并发症的发生，达到满意的治疗效果。Objective To discuss the choice of surgical approach to tumors （ lesions ） of the PTV （posterior third ventricle ） in children. Methods 21 cases of PTV tumors which were admitted consecutively from May 2004 to March 2007 were reviewed and analyzed retrospectively. 16 cases of PTV tumors, whose 2/3 located anterior to the tectum of the midbrain were removed via the transcallosal - fomix approach; 5 cases of PTV tumors, whose 2/3 located posterior to the teetum of the midhrain were removed via the occipital transtentorial approach. Results Among the 21 cases, 18 cases were totally removed; 3 cases were nearly totally removed. No patients were in coma after operation. No severe morbidity or mortality. Conclusions Regarding the rectum of the midhrain as a landmark, we can choose one of the surgical approaches mentioned above according to the location and growth direction of the tumor in PTV - either mostly anterior or mostly posterior to the rectum of the midhrain. The choosing of the proper surgical approach enables the tumor being exposed extensively and removed satisfactorily with minimal invasion to the important normal structure and with less complications.

关 键 词：儿童 脑肿瘤 第三脑室 后部 手术入路 

分 类 号：R739.41[医药卫生—肿瘤]