侧脑室肿瘤的临床分型及显微手术策略  

Clinical classification and microsurgical strategies of lateral ventricle tumors

作　　者：范振[1] 杨春春[1] 魏祥品[1] 钱若兵[1] 牛朝诗[1] 姜晓峰[1] 傅先明[1] 

机构地区：[1]安徽医科大学附属省立医院神经外科,230001

出　　处：《中国临床神经外科杂志》2011年第8期452-455,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨不同临床类型的侧脑室肿瘤显微外科治疗的手术入路选择、手术技巧,以提高其临床疗效。方法回顾性分析2007年2月至2009年6月收治的51例侧脑室肿瘤患者的临床资料。根据肿瘤性质、临床分型合理选择手术入路:经纵裂胼胝体入路手术5例,经皮层切开入路手术46例。术后密切随访,并进行Karnofsky操作评分(KPS)以评估预后。结果术后病理提示良性或低度恶性肿瘤30例,全切除23例,大部分切除7例;恶性肿瘤21例,全切除8例,大部分切除13例。48例随访12～50个月,29例良性或低度恶性肿瘤患者中,KPS>80分25例,60～80分4例,有癫痫发作5例。19例恶性肿瘤患者中,KPS>80分者5例,60～80分者3例,<60分者1例;死亡10例。结论根据侧脑室肿瘤的临床类型合理选择手术入路进行显微外科手术切除,可减少神经功能缺损的发生,降低病残率、死亡率;恶性肿瘤术后放、化疗等综合治疗对改善预后有重要意义。Objective To investigate the operative approach and technique of microsurgery for the lateral ventricle tumors of different clinical types in order to enhance the curative effect on them.Methods The clinical data of 51 patients with lateral ventricle tumors,who underwent microsurgery from February,2007 to June,2009,were analyzed retrospectively.According to the tumorous nature and clinical types,of 51 patients,5 underwent the microsurgery through transcallosal approach and 46 through the transcortical approach.The prognoses were assessed by the Karnofsky Performance Scale （KPS）.Results The pathological examination showed that there were benign or lowly malignant tumors in 30 patients,of whom,23 received total resection of the tumors and 7 great part and there were malignant tumors in 21 patients,of whom,8 received total resection of the tumors and 13 great part.Forty-eight patients （29 patients with begin or lowly maligna tumors and 19 ones with malignant tumors） were followed up from 12 to 50 months.KPS was more than 80 points in 25 patients and KPS ranged from 60 to 80 points in 4 of 29 patients with benign or lowly malignant tumors,in whom,5 suffered from epilepsy after the surgery.KPS was more than 80 points in 5 and KPS ranged from 60 to 80 points in 3 and KPS was less than 60 points in 1 of 19 patients with malignant tumors,in whom,10 died during the following-up period.Conclusion The disabled and dead rates may be reduced by microsurgery through the appropriate approach selected according the tumors type in the patietns with laternal ventricle tumors.

关 键 词：侧脑室 肿瘤 显微外科 手术入路 分型 

分 类 号：R739.41[医药卫生—肿瘤] R651.11[医药卫生—临床医学]