经翼点入路鞍区肿瘤切除术后继发小脑出血并脑积水的治疗分析  

Analysis on treatment of secondary cerebellar hemorrhage and hydrocephalus after sellar tumor resection by pterional approach

作　　者：曹轲[1] 杨文进[1] 吴晨星[1] 郭义君[1] 杜固宏[2] 童武松[1] CAO Ke;YANG Wen-jin;WU Chen-xing;TONG Wu-song(Department of Neurosurgery,Shanghai Pudong New Area People＇s Hospital,Shanghai 201200,China;Corresponding author)

机构地区：[1]上海市浦东新区人民医院神经外科,上海201200 [2]上海华山医院神经外科

出　　处：《临床神经外科杂志》2018年第5期372-376,共5页Journal of Clinical Neurosurgery

基　　金：上海市浦东新区卫生和计划生育委员会重点学科群项目(PWZxq2017-02);特色专病项目(PWZzb2017-09)

摘　　要：目的探讨经翼点入路鞍区肿瘤切除术后继发小脑出血并急性脑积水的治疗方法、疗效及依据,以及该病的发病机制。方法分析1例表现单眼视力下降,经翼点入路鞍区肿瘤切除术后继发小脑出血并急性脑积水患者的资料。患者术后出现并发症后,采用脱水、消肿及间断腰穿释放血性脑脊液等保守治疗方案治疗。并结合相关文献对该并发症的发病原因、治疗方法及理论依据进行分析。结果本例患者经采用非手术的保守治疗方案治疗1周后,控制住了小脑出血和脑积水的进展;治疗2周后小脑内血肿基本吸收,急性脑积水完全消除。结论对于鞍区肿瘤术后继发小脑出血及急性梗阻性脑积水,在患者病情稳定的情况下,通过保守治疗保持脑脊液循环通道始终处于畅通状态,可控制病情进展;并可在梗阻性脑积水的急性期将其根治。Objective To investigate the experience of successful cure with conservative treatment on a case of complication of secondary cerebellar hemorrhage and acute hydrocephalus after sellar tumor resection with pterional approach and analyze the mechanism of pathogenesis and the basis of treatment. Methods The data of one patient of sellar tumor resection with pterional approach with the main clinical manifestation as decreased monocular visual vision was analyzed, who underwent the complication of secondary acute cerebellar hemorrhage and acute hydrocephalus and was successfully treated by conservative treatment of dehydration, subsidence of swelling. The pathogenesis and curing experience and relevant theoretical basis of the complication were also deeply analyzed and investigated. Results For the patient with secondary acute cerebellar hemorrhage and acute hydrocephalus after sellar tumor resection with pterional approach, non-operational conservative treatment of strengthen hemostasis, dehydration, subsidence of swelling, and lumbar puncture hadcontrolled the progress of acute cerebellar hemorrhage, and also completely cured postoperative secondary acute hydrocephalus. Conclusion For secondary acute cerebellar hemorrhage and acute obstructive hydrocephalus after sellar tumor resection, if in stable condition, maintain an always unimpeded cerebrospinal fluid circulation channel with conservative treatment can control the progress of the disease, and can also completely cure obstructive hydrocephalus acute in its acute phase.

关 键 词：鞍区肿瘤 术后 并发症 小脑出血 脑积水 

分 类 号：R739.4[医药卫生—肿瘤]