颅眶沟通瘤的诊断与显微外科手术治疗  

THE DIAGNOSIS AND MICROSURGICAL MANAGEMENT OF CRANIAL ORBITAL TUMORS

作　　者：费舟[1] 章翔[1] 郭庆东[1] 蒋晓帆[1] 付洛安[1] 张剑宁[1] 王占祥[1] 白红民[1] 

机构地区：[1]第四军医大学西京医院

出　　处：《解放军医学杂志》2002年第7期575-576,共2页Medical Journal of Chinese People's Liberation Army

基　　金：国家自然科学基金资助课题 (编号 39870 673)

摘　　要：对 38例颅眶沟通瘤诊断与手术治疗进行回顾性研究 ,以期进一步提高此类肿瘤的疗效。全组 38例 ,其中男 2 9例 ,女 9例 ,年龄 4～ 5 4岁 ,平均 32 2岁。肿瘤在颅内位于前颅凹 33例 ,中颅凹 5例。35例 (92 1% )出现与视器有关的症状 ,2 3例 (6 0 5 % )有头痛、头晕等颅内压增高症状。部分病例行血管造影及术前颈外供瘤血管栓塞术。采用显微外科技术与不同手术入路切除肿瘤 ,全切者 2 8例 ,大部切除者 10例 ,均恢复良好 ,术后无死亡。随访 7个月～ 9年 ,2 4例完全恢复健康 ,6例生活需要照顾 ,5例有不同程度恢复 ,3例恶性肿瘤在术后 3个月～ 2年死于多器官功能衰竭。颅眶沟通瘤多以视器改变为主要临床表现 ;对颅眶沟通的高血运肿瘤 ,术前栓塞可以明显减少手术中出血 ,增加全切肿瘤的可能性 ;采用不同手术入路及多学科联合 ,在显微镜下切除肿瘤 。A retrospective study was made on the diagnosis and microsurgical management of 38 cases of cranial orbital tumors treated in our hospital in order to improve its clinical outcome. 29 males and 9 females with an age between 5 ～45 years (mean 32 2 years) were included in this series. 33 cases had their tumor located in anterior fossa, and 5 in middle fossa. 35(92 1%) cases showed malfunction of optic organs. 23(60 5%) cases had symptoms of intracranial hypertension. DSA and preoperative embolization of supplying arteries of tumors were performed in some cases. Microsurgical techniques and different approaches were used to remove tumors. 28 cases received total removal and others subtotal resection. No postoperative morbidity was found. 7 months～9 years follow up study showed that 24 cases resumed normal life, 6 had a dependent life and 5 had a certain recovery. One of the most frequent clinical manifestations of cranial orbital tumor was disorders in optic organs. The preoperative embolization of supplying arteries of tumors makes it possible to decrease bleeding during operation and increase the possibility to remove the total tumor. Microsurgical and piecemeal techniques as well as combined approaches may improve its clinical results.

关 键 词：颅眶沟通瘤 神经外科 诊断 显微外科 手术治疗 

分 类 号：R739.41[医药卫生—肿瘤] R739.7[医药卫生—临床医学]