显微神经外科技术治疗颅咽管瘤

Microsurgical techniques of resection for craniopharyngioma.

目的研究颅咽管瘤的显微神经外科手术技巧和临床效果。方法回顾性分析采用显微神经外科技术治疗的28例颅咽管瘤患者的临床资料。结果全切除24例(86%)、近全切除4例(14%)。尿崩症、高热、水电解质平衡失调是颅咽管瘤切除术后较常见的并发症。结论入路的合理选择、显微技术的应用、术中垂体柄的辨认与保护及脑室外引流的应用对提高肿瘤全切除率、降低致残率和病死率有重要的临床意义。

Objective To summarize of the micresurgical techniques and clinical efficacy of resection for craniopharyngiomas. Methods Clinical data of twenty-eight patients with craniopharyngioma treated by microsurgical techniques were analyzed retrospectively. Results Total removal was achieved in 24 patients （ 86% ） and subtotal in 4 （ 14% ）. The postoperative diabetes insipidus ,high fever,and imbalance of electrolytes was the common complications. Conclusion The appropriate surgical approaches, microsurgical techniques, identification and preservation of the hypothalamic-pituitary stalk, and external ventricle drainage play an important role in increasing total removal rate and reducing disability and mortality.