颅内外肿瘤的显微外科治疗(英文)

Microsurgical management of intracranial and extracranial tumors

目的 回顾性分析我院 1992年至今采用术前供血动脉栓塞和显微外科治疗的 6 0例颅内外肿瘤患者 ,为改善此类疾病的预后提供依据。方法 男性患者 4 2例 ,女性 18例 ,年龄 11月～ 6 8岁 ,平均 32 .2岁。肿瘤分布于前颅窝 30例 ,中颅窝 16例 ,后颅窝 14例。 4 8例术前行DSA检查 ,其中4 5例经颈外动脉栓塞颞浅动脉 ,耳后动脉和硬脑膜动脉等肿瘤供血动脉。采用不同手术入路和显微外科技术切除肿瘤。结果 4 2例肿瘤被全切 ,其余为次全切 ,术后致残率为 0。 7月～ 7年的随访结果表明 34例重新开始正常生活 ,18例生活不能完全自理 ,8例部分恢复。结论 术前肿瘤供血动脉栓塞可减少术中出血 ,增加肿瘤全切的可能性。

Objective A retrospective study had been made on the preoperative embolization of supplying arteries and microsurgical management of 60 cases of tumors with intracranial and extracranial extension treated in our hospital since the year 1992 till now in order to improve the clinical outcomes of these diseases.Methods There were 42 males and 18 females with an age from 11 months to 68 years (mean 32.2 years) in this series. Thirty cases were located in anterior fossa, sixteen in middle fossa and fourteen in posterior fossa. Forty eight cases were examined by DSA and preoperative embolization of supplying arteries of tumors were made for 45 cases. The embolized arteries included superficial temporal artery , posterior auricular artery and meningeal artery and so on from external carotid artery. Microsurgical techniques and different approaches had been utilized to remove tumors. Results Forty two cases had been totally removed and others subtotally resected. The postoperative morbidity was zero. Seven months to seven years' follow up study showed that 34 cases resumed normal life and 18 cases with dependent life and 8 with recovery to some extent.Conclusion The preoperative embolization of supplying arteries of tumors makes it possible to reduce bleeding during operation and increase the possibility to remove tumors totally. Microsurgical and piecemeal techniques as well as combined approaches may result in improved clinical results .