桥小脑角及斜坡肿瘤手术并发症的原因分析

Investigation of causes of severe surgical complications of tumors located in CPA or clival area

目的探讨桥小脑角及斜坡区肿瘤手术严重并发症发生的原因。方法回顾性分析了宣武医院1998年至2004年86例该区域手术治疗患者的临床资料。结果 86例患者中,术后脑干损伤3例(2例死亡),小脑肿胀导致脑疝死亡1例,瘤腔血肿2例,后组颅神经损伤19例(10d内症状减轻8例)。结论手术者预测不同肿瘤患者可能出现局部解剖关系的变化和手术中可能出现的困难,结合手术中的具体情况,运用良好的手术技巧,这一区域手术的严重并发症的发生是可以减少的。

Objective To explore causes of severe surgical complications of tumors located in CPA or clival area and to summarize experiences and lessons in order to reduce the ratio of complications. Methods 86 cases who were treated by operation during 1998-2004 with tumors in these area were studied retrospectively. Materials of all patients were reviewed and analyzed. Results Among 86 cases, severe surgical complications occurred in 25cases. There were brain stem injury in 3 cases （two died） , cerebellar edema in one case （died） , postoperative hematoma in 2 cases, cranial nerves injury in 19 cases （8 eases recovered in 10 days） - Conclusions Severe surgical complications could be reduced if surgeons can predict different topographic changes and the difficulties of operation in each patients combining with specific conditions in operations and try to use best technique.