锁孔开颅显微手术治疗颅内病变73例  

Treatment of Intracranial Lesions by Microsurgery through Keyhole Approach in 73 Patients

作　　者：周毅[1] 敖祥生[1] 黄星[1] 刘汉东[1] 张青松[1] 徐廷伟[1] 陈彬[1] 

机构地区：[1]襄樊市中心医院神经外科,湖北襄樊441021

出　　处：《中国临床神经外科杂志》2004年第1期6-7,共2页Chinese Journal of Clinical Neurosurgery

摘　　要：目的介绍应用锁孔开颅手术技术73例的体会,并探讨其治疗效果。方法73例颅内病变患者,包括垂体腺瘤31例,颅咽管瘤7例,听神经瘤13例,颈内-后交通动脉瘤3例,桥小脑角脑膜瘤2例,小脑血管网织细胞瘤2例,三叉神经痛2例,颞极蛛网膜囊肿2例,高血压脑出血11例。采用眶上锁孔开颅38例,乳突后锁孔开颅19例,翼点锁孔入路5例,颞部锁孔入路11例。结果55例肿瘤病变全部或次全切除46例,大部切除9例;3例动脉瘤夹闭顺利;其他病例均达到手术目的。1例因牵拉致额底挫伤,但无临床症状。1例听神经瘤术后术野出血,经再次手术治愈。没有与手术入路有关的并发症。结论锁孔手术技术以创伤小为其优点。深部病变更能体现锁孔手术的优越性,特别是蝶鞍和桥小脑角区病变。有选择性的应用锁孔开颅技术,效果优于常规开颅。Objective To introduce the experience in treating intracranial lesions by microsurgery through keyhole approach. Methods Of the 73 patients, 31 suffered from pituitary adenoma, 7 craniopharyngiomas, 13 acoustic neuromas, 3 aneurysms of the posterior communicating arteries, 2 meningiomas in cerebellopontine angles (CPA), 2 trigeminal neuralgia, 2 cerebellar hemangioblasto-mas, 2 arachnoid cysts, and 11 intracranial hematomas. The operative approaches included supraorbital keyhole approach in 38, post-mastoidal in 19, pterion in 5, and temporal in 11. Results Of 55 patients with intracranial tumors, 46 received total or subtotal excision of the tumors and 9 partial. Three aneurysms were well clamped. The results of the other cases were also good. No complication related to the operative approach occurred. Conclusions The keyhole approach is minimally invasive, and especially suitable for treating the intracranial deep lesions.

关 键 词：显微手术 锁孔 开颅术 

分 类 号：R739.41[医药卫生—肿瘤] R743.34[医药卫生—临床医学]