经鼻蝶窦入路显微手术切除鞍膈内型颅咽管瘤  

The transsphenoidal surgery for the intrach＇aphragmatic craniopharyngiomas

作　　者：王亮[1] 倪明[1] 贾旺[1] 关树森[1] 贾桂军[1] 张俊廷[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科中心,100050

出　　处：《中华神经外科杂志》2012年第9期906-909,共4页Chinese Journal of Neurosurgery

摘　　要：目的探讨经鼻蝶窦入路切除鞍膈内型颅咽管瘤的手术适应证和疗效。方法收集自2005年10月至2010年12月经手术治疗且病理证实的鞍膈内型颅咽管瘤10例，通过随访进行回顾性分析。结果男：女=3：7，发病年龄在15～48岁之间，多以视力减退、闭经泌乳和头痛作为首发症状，女性尤以闭经泌乳常见。病变呈囊性或囊实性。2例全切除，8例近全切除。1例发生术后脑脊液鼻漏。10例均得到随访，闭经泌乳、视力下降、尿崩症状改善明显，2例复发。结论经鼻蝶窦入路显微手术治疗鞍膈内型颅咽管瘤以力争全切肿瘤为原则，掌握手术适应证和合理运用显微外科技术可显著改善此类肿瘤患者的预后。Objective To investigate the indications and outcomes of microsurgical resection of intradiaphragmatic craniopharyngiomas via .transsphenoidal approach. Methods Ten cases of of the intradiaphragmatic craniopharyngiomas were treated in our hospital between Otc. 2005 and Des. 2010. The clinical characteristics and outcome of them were reviewed. Results There were 3 male and 7 female patients. The age of presentation ranged from 15 to 48 years. Visual loss, amenorrhea - galactorrhea, and headaches were the most common clinical symptoms. All of the 10 lesions were given operations. Two lesion was totally removed, and eight lesions were subtotally resected. Postoperative cerebrospinal fluid leakage occurred in one case. All the patients were alive at the latest follow - up. The follow - up data showed that the preoperative symptoms were relieved postoperatively of different degree. Conclusions The aim of the transsphenoidal surgery for the intradiaphragmatic craniopharyngiomas is to get totally resected. When used the operative dications appropriately and by neurosurgeons with extensive experience in pituitary surgery, the transsphenoidal surgery for the intradiaphragmatic craniopharyngiomas can offer excellent results with minor risks.

关 键 词：颅咽管瘤 鞍膈内 经蝶窦手术 显微外科手术 

分 类 号：R739.41[医药卫生—肿瘤]