颅咽管瘤术后并发症与机制探讨

Complications and the mechanism after operation for craniopharyngioma

目的分析颅咽管瘤的治疗结果和并发症,探讨其发生机制。方法回顾性分析56例颅咽管瘤病人的治疗效果和随访情况。结果各种治疗方法均具有相应的并发症和复发可能,总病死率12.5%。下丘脑损害后症状复杂,发生率60.7%;垂体功能低下发生率48.2%;术后视力减退发生率14.3%。其他并发症还有无菌性脑膜炎、脑脊液鼻漏、暂时性偏瘫、缄默性失语、创伤性动脉瘤、癫疒间等。平均随访1.98年,复发率17.9%。结论颅咽管瘤并发症发生率高,机制复杂;采用微创治疗手段可提高疗效。

Objective To investigate the currative effect and mechanisms of complications by analyzing the treatment results of craniopharyngiomas. Method Mortality, morbidity, and recurrence of craniopharyngioma in 56 patients were analyzed retrospectively. Results Treatment methods have specific mortality, morbidity, recurrence rates respectively. Total mortality was 12.5%. Incidence rate of hypothalamus injury was 60.7%, with complicated symptoms. 48.2% of the patients had pituitary hypofunction, and 14.3% had visual dysfunction or visual field defect. Other complications were non-bacterial meningitis, nasal CSF fistula, transient hemiparesis mutism, traumatic aneurysm, epilepsy, etc. Average follow-up was 1.98 years, and the recurrence rate was 17.9%. Conclusions Treatment of craniopharyngioma is very difficult, with a high rate of serious complications and complex pathogenesis, thus prognosis being not very good. Using minimally invasive technique can improve therapeutic effects.