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1、经眉弓锁孔入路治疗颅内病变(附290例分析)作者：郑永口单位:华中科技大学同济医学院，湖北武汉430030【摘要】目的总结经眉弓锁孔入路治疗颅内病变的手术经验。方法冋顾性分析近10年來收治的290例颅内病变的手术经验。病变位于鞍区279例，颅前窝9例，第三脑室2例。均行经眉弓锁孔入路病变切除术。结果病变全切除214例(73.8%),次全切除76例(26.2%)O206例术前视力障碍病人中，术后1周内视力有所改善158例(76.7%)。术后出现暂时性尿崩24例(8.3%)；脑脊液鼻漏5例(1.7%),经保守治疗后恢复。107例功能性腺瘤病人中，术后1周内分泌恢复
2、止常水平56例(52.3%),其余均有不同程度的下降。1例无功能垂体腺瘤病人术后第5天死于心肌梗死。对180例病人术后随访1年，复发15例。结论经眉弓锁孔手术是一种安全、有效的微创手术，值得进行深入研究和广泛应用。【关键词】经眉弓锁孔入路脑肿瘤显微外科手术Transorbitalkeyholeapproachforintracranialdiseases:analysisof290casesZHENGYongri1,GUOMian2,LIQingsong2,etal.1.TongjiMedicalCollege,HuazhongUniversityofScie
3、nces&Technology,Wuhan430030,China;2.DepaitmentofNeurosurgery,SecondAffiliatedHospitalofHarbinMedicalUniversity,Harbin150086,ChinaAbstract:ObjectiveTosummarizeoperativeexperienceviaTransorbitalkeyholeapproachforintracranialdiseases.MethodsSurgicalexperieneefrom290patientswithintr
4、acranialdiseasesoperatedinthepast10yearswereretrospectivelyanalyzed・Thetumorwaslocatedinsellarin279cases,formerfossain9,andthethirdventriclein2.Patientswerealloperatedonthroughthesupraorbitalkeyholeapproach・ResultsTotalresectionoftumorwasachievedin214cases(73.8%),andsubtotalin76(26.
5、2%).In206patientswithpreoperativevisualimpairment,158(76.7%)obtainedvisualimprovement1weekaftertheoperation.Temporarydiabetesinsipidusoccurredin24(8.3%)casesandcerebrospinalfluidfistula,recoveredafterconservativetreatment,in5(1.7%).In107patientswithfunctionaladenoma,endocrinehadreco
6、veredtonormallevelinoneweekin56(52.3%)cases,andtheresthadvaryingdegreesofdecline.Onecaseofnon-functioningpituitaiyadenomadiedofmyocardialinfarctionatday5afterthesurgery.Onehundredandeightypatientswerefollowedupfor1yearwithrecurrencein15.ConclusionThesurgeryviasupraorbitalkeyholeappr
7、oachisasafeandeffectiveminimallyinvasiveoperation,thusdeservingfurtherstudyandwiderapplication・Keywords:transorbitalkeyholeapproach;brainneoplasms;microsurgery1998年9月~2008年1月，我科采用经眉弓锁孔入路治疗颅内病变290例，手术创伤小，病变全切率高，病人恢复快，取得了良好的疗效，现报告如下。1对象与方法1.1一般资料男性130例，女性160例;年龄6〜78岁,平均36.8岁。病程1周〜18年,
8、平均10个月。其中单眼视力下降110例
