摘要
目的评估幕下小脑上入路切除松果体区肿瘤的优点和缺点。方法回顾性分析53例用该种手术入路所切除肿瘤的临床表现、手术方法、肿瘤全切程度和术后并发症等。结果28例硅微镜下全切，15例大部切除，8例部分切除，2例活检。术后所有患者均出现不同程度的气颅，但在3—5d后消失。术后38例患者出现眼球上视和会聚功能受限，均在术后2周内恢复。4例出现进行性加重脑积水需行脑窜-腹腔分流术。2例患者术后肿瘤残腔出血，虽经积极手术治疗仍死亡。结论幕下小脑上入路能克服经枕穿幕入路牵拉枕叶、切开小脑幕的缺点，术中解剖定位清晰，但暴露范围有限，不适于肿瘤向幕上或偏侧生长者。
Objective To estimate the advantage and disadvantage of infratentorial-supracerebellar approach for removal of pinal region tumor. Method 53 cases of pineal region tumor were retrospectivly reviewed including clinical manifestations, operative approach , degree of tumor resected and complication related to approach. Results Of 53 cases, 28 cases were totally removed, snbtotally removed in 15 eases, partly in 8 cases and biopsy in 2 cases. After operation air presented in supratentorial cavity in all cases, but disappeared among 3-5 days. 38 cases showed limited upgaze and convergency which lasts several days to 2 weeks. 4 cases needed to be shunted to eliminate developing hydrocephalus. 2 cases developed postopertive hemorrhage in the residual mass, and undergone second operation and died. Conclusions Infratentorial- supracerebellar approach can avoid retracting occipital lobe and dividing tent, but it is preferable for small and medium size tumors without lateral expansion.
出处
《中华神经外科杂志》
CSCD
北大核心
2008年第9期676-678,共3页
Chinese Journal of Neurosurgery
关键词
松果体瘤
手术后并发症
幕下小脑上入路
Pinealoma
Postoperative complications
Infratentorial supracerebellar approach
