经颅显微外科切除鞍区肿瘤临床资料分析和手术入路的选择.pdf

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1、南通大学学报(医学版)·274·JoumalofNanton~UniversityfMedicalSciences)2014：34(4经颅显微外科切除鞍区肿瘤临床资料分析和手术入路的选择杨柳。严耀华，陈建国，李剑，顾志恺，周非(南通大学附属医院神经外科，南通226001)f摘要】目的：总结经颅显微外科切除鞍区肿瘤的经验，探讨经颅切除鞍区肿瘤手术人路的选择。方法：回顾分析南通大学附属医院神经外科自2012年5月-2014年3月手术的鞍区肿瘤80例f脑膜瘤56例、垂体瘤12例、颅咽管瘤9例、皮样囊肿2例、神经内分泌源恶性肿瘤1例)的临床资料；手术人路包括翼点入路

2、、额下入路和额外侧人路，肿瘤采用显微外科技术切除。分析全切除率、手术效果和并发症发生的情况。结果：采用翼点人路者50例，全切除率为66．0％：采用额下人路者16例，全切除率为75．0％：采用额外侧人路者14例，全切除率为71．4％。结论：显微手术是治疗鞍区肿瘤的主要手段，选择手术入路时应根据肿瘤的大小、生长方式以及肿瘤和周围重要结构的关系，遵循最优化和个体化原则．结合手术者的经验来决定f关键词1鞍区肿瘤；手术人路；显微手术【中图分类号】R739．41[文献标志码】A[文章编号]1674—7887(2014)04—0274—04Thechoiceoftrans

3、cranialmicrosurgeryapproachesforseUarregiontumorsandtheclinicaldataanalysisYANGLiu，YANYaohua，CHENJianguo，LIm，GUZhikai，ZHOUFei(DepartmentofNeurosurgery，theAffiliatedHospitalofNantongUniversity，Nantong226001)【Abstract】Objective：Tosummarizetheoperationexperienceoftranscranialmicrosurg

4、eryforsellarregiontumorsandana—lyzetheeffectofdifferentapproachesinsurgery．Methods：Aretrospectiveanalysiswasmadeon80casesofsellarregiontu—moroperatedfromMay2012toMarch2014indepartmentofneurosurgeryoftheAffiliatedHospitalofNantongUniversitywhichallremovedbyusingmicrosurgicaltechniqu

5、ewiththreedifferentsurgicalapproach(trans-pterional，trans—subfronta，andtrans—frontallateralapproach)，including56casesofmeningiomas，12casesofpituitaryadenoma，9casesofcranio—pharyngioma，2casesofdermoidcyst，andlcasesofneuroendocrinetumor．Theremovalrate，surgeryeffectandcomplica—tionswe

6、reanalyzed．Resuhs：Trans-pterionalapproachwereadoptedin50casesandthetumortotalresectionratewas66．0％；trans-subfrontalapproachwereadoptedin16casesandthetumortotalresectionratewas75．0％：trans—f如ntal】ateralapproachwereadoptedin14casesandthetumortotalresectionratewas71．4％．Conclusion：Micro

7、scopicsurgeryisthemainwayofremovesellarregiontumors．Thesurgicalapproachshouldbechosedfollowingtheprincipleofindividualandopti—mization．Thechoiceshouldbemadeaccordingtothegrowthpatternoftumor，thetumorsize，therelationshipbetweentumorandsmToundingstructures，andthehabitofsurgeon．【Keywo

8、rds】sellarregiontumor；tran