枕骨大孔区良性肿瘤的显微手术切除(附17例临床分析)  

Microsurgical Resection of Benign Tumors at the Foramen magnum(A report of 17 Cases)

作　　者：陆天宇 俞天赋 刘浩[1] 陈维涛 倪红斌[1] Lu Tianyu;Yu Tianfu;Liu Hao(Department of Neurosurgery,NanJin Drum Tower Hos-pital,the Affiliated Hospital of Nanjin University Medical School,NanJin JiangSu,210008)

机构地区：[1]南京大学医学院附属南京鼓楼医院神经外科,南京210008

出　　处：《立体定向和功能性神经外科杂志》2020年第2期91-95,共5页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的探讨经后正中入路显微手术切除枕骨大孔区良性肿瘤的手术要点及疗效,并结合术中神经电生理监测探讨神经及脊髓保护的方法及安全性。方法回顾我科2012年1月~2019年6月收治17例枕骨大孔区良性肿瘤病例,手术采用后路正中入路,术中结合电生理监测进行神经及脊髓保护。结果本组病例17例,其中脑膜瘤4例,神经鞘瘤9例,神经纤维瘤2例,血管母细胞瘤2例。全切14例,次全切3例。本组术前存在颈肩部疼痛、上肢疼痛、麻木及肩部紧缩感等症状完全缓解13例,好转2例,随访0.5~8年均出现恢复良好。遗有呼吸困难气管切开2例,无脑脊液漏及感染、死亡发生。结论后正中入路显微手术切除枕骨大孔区良性肿瘤疗效确切,安全性高。Objective To explore the operative key points of microsurgical resection of be-nign tumors in Foramen magnum by posterior median approach.To explore the methods of nerve and spinal cord protection with intraoperative electrophysiological monitoring.Methods We fol-lowed up 17patients with benign tumors in Foramen magnum who received tumor resection via posterior median approach in our department from January 2012to June 2019.Intraoperative elec-trophysiological monitoring was used to protect nerves and spinal cord during tumor resection.Results A total of 17cases were in this group,including 4cases of meningioma,9cases of schwannoma,2cases of neurofibroma and 2cases of hemangioblastoma.However,Total resection of tumor was performed in 14cases and subtotal resection was performed in 3cases.13cases showed complete relief of the pain and numbless of neck,shoulder and upper limb.2cases showed incomplete relief after the operation and totally relief in the follow up period(0.5~8years,5.4 years on average).Tracheostomy with dyspnea was performed in 2cases.No other complications as intracranial infection or deaths showed in the following-up period.Conclusion Posterior me-dian approach is an effective and safe method for microsurgical resection of benign tumors at the foramen magnum.

关 键 词：枕骨大孔区肿瘤 显微外科治疗 后正中入路 

分 类 号：R739.41[医药卫生—肿瘤]