脑干桥延部肿瘤显微外科手术治疗及并发症的防治  

Treatment of polls and oblongata tumors with microsurgery and perioperative complications

作　　者：张国锋[1] 胡卫星[1] 顾培元[1] 陈功[1] 史德志[1] 顾斌[1] 张春[1] 李俊漾[1] 幸标[1] 魏栋[1] 

机构地区：[1]南京医科大学第一附属医院神经外科,210029

出　　处：《中华神经外科杂志》2013年第4期367-369,共3页Chinese Journal of Neurosurgery

基　　金：江苏省医学重点人才工程（135工程）资助（RC2002075）

摘　　要：目的研究脑干桥延部肿瘤的临床特点，探讨其手术方法及术后并发症防治。方法回顾性分析23例显微手术治疗的脑干桥延部肿瘤病例资料，包括临床表现、影像学检查、手术入路及并发症等。结果23例中全切除15例，次全切除4例，大部切除4例。胶质瘤15例，海绵状血管瘤3例，血管母细胞瘤4例，恶性淋巴瘤1例。围手术期无死亡病例，症状加重6例，新增神经系统症状4例，颅内感染1例，神经源性肺水肿及延髓麻痹1例。结论脑干桥延部肿瘤术后并发症多且严重，恰当的手术入路、精细的显微手术操作及预防和处理术后并发症有助于提高治疗效果。Objective To study the clinical characteristics of tumors at the place between pons and oblongata, the methods of microsurgical treatment, and treatment for complications of microsurgery. Methods The 23 patients undergoing surgical treatment of tumors originated from pons and medullary were reviewed retrospectively. Preoperative clinical presentation and lesion characteristics, adopted surgical approach and complications were analyzed. Results All cases in this group were accepted microsurgical treatment. Numbers of total resection, subtotal resection, and partial resection of tumors were 15, 4 and 4, respectively. Cases of glioma, cavernous malformation, hemangioblastoma, and lymphoma were 15, 3, 4 and 1, respectively. Perioperative complications of worsening original symptoms, new neurological symptoms, intracranial infection, and neurogenic pulmonary edema and bulbar paralysis occupied 6, 4, 1, 1, respectively. There was no death in perioperative. Conclusions There are many kinds of tumors at the place between pons and oblongata, and many patients had severe perioperative complications. Appropriate surgical indications and approaches, microsurgical operation, the prevention and treatment to the postoperative complications, contribute to improve the treatment effect of tumors at the place of pons and oblongata.

关 键 词：显微外科手术 并发症 脑干桥延部肿瘤 

分 类 号：R73[医药卫生—肿瘤]