经额下-第三脑室联合入路切除巨大垂体腺瘤与颅咽管瘤24例报告  

Ressection of Pituitary Macroadenoma and Craniopharyngioma via Combination of Transsubfrontal and the Third Ventricular Approaches (Report of 24 cases)

作　　者：楚功仁[1] 张佳栋[1] 胡明伟[1] 陈航[1] 史锡文[1] 

机构地区：[1]河南省人民医院神经外科,郑州450003

出　　处：《中国临床神经外科杂志》2002年第4期205-206,共2页Chinese Journal of Clinical Neurosurgery

摘　　要：目的 介绍经额下-第三脑室联合入路切除巨大垂体腺瘤及颅咽管瘤的途径、体会及疗效。方法 额部开颅,先经侧脑室-室间孔达第三脑室,切除第三脑室肿瘤,此时因侧脑室及第三脑室已经开放,颅内压明显降低,可以很容易地抬起额叶,显露并切除鞍上及鞍内肿瘤。结果 4例全切除,20例次全切除,无死亡病例。24例术前均有不同程度视觉障碍,其中10例在住院期间视力视野已有改善,8例术后出现尿崩,经治疗1～2周好转。结论 当垂体瘤或颅咽管瘤长入第三脑室时,经额下-第三脑室入路是较理想的手术入路。Objective To introduce the curative effect and experience of resection of the pituitary macroadenomas and craniopharyngiomas via the combination of the transsubfrontal and third ventricular approaches. Methods As the first operative step, the tumor of the third ventricle was resected via a lateral ventricle-interventricular foramen approach to the third ventricle, and then both the suprasellar and intrasellar tumors were better exposed and resected because the frontal lobe could be easily raised due to obvious decrease in the intracranial pressure by opening the lateral and third ventricles. Results Total removal of the tumors was achieved in 4 cases and subtotal in another 20. No patients died. Various preoperative visual disfunction was present in all the patients, of whom, 10 had improvement of the visual function after the operation. Eight patients experienced postoperative diabetes insipidus, but they were improved 1 -2 weeks after the proper management. Conclusion The resection of the tumors via the combined transsubfrontal-ventriclar approach is an ideal option in the patients with pituitary tumors or craniopharyngiomas, which have invaded the 3rd ventricle.

关 键 词：垂体腺瘤 颅咽管瘤 手术入路 经额下-第三脑室联合入路 

分 类 号：R739.41[医药卫生—肿瘤] R736.4[医药卫生—临床医学]