颅咽管瘤并发颅内动脉瘤的病因及治疗  

The etiology and treatment of craniopharyngioma with aneurysm

作　　者：胡孟庆 刘方军[1] 周忠清[1] 孙玉明[1] 钱海[1] 雷霆 向鑫 石祥恩[1] Hu Mengqing;Liu Fangjun;Zhou Zhongqing;Sun Yuming;Qian Hai;Lei Ting;Xiang Xin;Shi Xiang′en(Department of Neurosurgery,Sanbo Brain Hospital,Capital Medical University,Beijing 100093,China)

机构地区：[1]首都医科大学三博脑科医院神经外科,北京100093

出　　处：《中国医师进修杂志》2022年第8期689-695,共7页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨颅咽管瘤并发颅内动脉瘤的发病机制及治疗方法。方法回顾性分析2014年3月至2019年10月在首都医科大学三博脑科医院治疗的7例颅咽管瘤并发颅内动脉瘤患者的病历资料。男5例,女2例。复发颅咽管瘤4例,初发1例,无复发2例。3例为血泡样动脉瘤,在颅咽管瘤切除后,予以显微缝合血泡样动脉瘤。3例为颈内动脉梭型动脉瘤:1例先行颌内动脉-桡动脉-大脑中动脉搭桥,动脉瘤孤立后,再予以切除颅咽管瘤;1例因肿瘤未复发仅行颌内动脉-桡动脉-大脑中动脉搭桥孤立动脉瘤;1例仅行颅咽管瘤切除,颈内动脉梭形动脉瘤予以观察。1例为大脑中动脉囊性动脉瘤,颅咽管瘤未复发,予以动脉瘤夹闭处理。结果所有患者术后未有严重并发症,随访期间颅咽管瘤未复发,治疗动脉瘤未复发,观察动脉瘤稳定。结论颅咽管瘤囊液的炎性刺激及手术本身是颅咽管瘤术后出现颅内动脉瘤的重要原因,选择合适的手术方式可以一次性完成颅咽管瘤的切除及颅内动脉瘤的处理。Objective To explore the etiology and treatment of craniopharyngioma with aneurysm.Methods Seven cases of craniopharyngioma with aneurysm from March 2014 to October 2019 treated in Sanbo Brain Hospital,Capital Medical University were retrospectively analyzed.Among the 7 patients,there were 5 males and 2 females.There were 4 cases of recurrent craniopharyngiomas,1 case of primary tumor and 2 cases of non-recurrence tumor.Three patients with blood blister-like aneurysms were treated with microsurgical suture after craniopharyngioma resection.Among the three cases with internal carotid artery fusiform aneurysm,1 case underwent craniopharyngioma resection after internal maxillary artery-radial artery-middle cerebral artery bypass and isolation of the aneurysm;1 case only underwent internal maxillary artery-radial artery-middle cerebral artery bypass and isolation of the aneurysm for non-recurrence tumor;1 case underwent craniopharyngioma resection and dynamic observation of aneurysm.One case with a cystic aneurysm of the middle cerebral artery was clipped and the craniopharyngioma did not relapse.Results All patients had no serious postoperative complications.During the follow-up period,there was no recurrence of craniopharyngioma,no recurrence of treated aneurysms,and the stability of aneurysms was observed.Conclusions Inflammatory stimulation of craniopharyngioma cystic fluid and operation itself are the important reasons for the occurrence of aneurysms after craniopharyngioma surgery.Choosing appropriate surgical methods can complete the removal of craniopharyngioma and the treatment of aneurysms at one time.

关 键 词：颅咽管瘤 血泡样动脉瘤 颈内动脉梭型动脉瘤 病因 治疗 

分 类 号：R739.41[医药卫生—肿瘤]