立体定向治疗颅脑病变

Treatment of brain deep lesions by stereotaxy

目的：探讨立体定向技术治疗脑深部病变的疗效。方法：利用ＡＳＡ—６０１Ｓ和Ｆｉｓｃｈｅｒ脑立体定向仪治疗８２例脑深部病变患者，行定向活检治疗２２例，血肿清除治疗５例，脑脓肿抽吸术２例，囊性颅咽管瘤置入Ｏｍｍａｙａ管治疗５３例。结果：活检确诊为胶质瘤１０例，生殖细胞瘤４例，脑寄生虫３例，肺癌脑转移４例，１例第三脑室后部病变活检为胶质细胞增生。４例胶质瘤行手术治疗后病情好转，其余肿瘤行放射治疗，有６例痊愈（４例生殖细胞瘤，２例转移性肿瘤）。３例寄生虫经对症治疗后痊愈；２例脑脓肿经抽吸、抗炎治疗后痊愈；脑血肿５例经治疗痊愈； ５３例颅咽管瘤置放 Ｏｍｍａｙａ管后３例痊愈（行囊内放疗），５０例好转。结论：立体定向治疗脑深部病变定位精确、损伤小、操作简便、安全可靠，值得提倡。

Objectives: To discuss the effect of stereotactic techniques in treating brain deep le- sions. Methods: Eighty - two patients with deep brain lesions were treated by fisher stereotactic appara- tus and ASA - 601S. Among these, stereotactic biopsy was performed in 22, clearance of haematoma in 5, aspiration of brain abscess in 2 and placement of Ommaya tube into cystic craniopharyngioma in 53. Results: All of the 22 biopsles were pathologically diagnosed, which included 10cases of glioma, 4 cases of germ cell tumor, 3 cases of brain parasite, 4 cases of metastatic lung tumor and case of hyperplasia of colloid cells at rear end of third ventricle. Tumor resection was performed in 4 patients with glioma and radiation therapy for other tumors. After the treatment, 6 Patients. were fully recovered(4 with germ cell tumou and 2 with metastatec tumor). All brain parasite, brain abscess and brain haematoma were cured. Three patients with craniopharyngioma were cured after the placement of Ommayatube(with ra- diation therapy inside the cyst), and others were improved. Conclusions: Stereotaxy has the advantag- es of precise location, less damage, easily manipulation and on the safe side. It is worth advocating.