侧脑室肿瘤42例临床分析

Clinical analysis on 42 cases of lateral ventricle tumor

目的探讨侧脑室肿瘤的临床特点、手术入路的选择和术后并发症的处理,为侧脑室肿瘤的诊治提供帮助。方法回顾性分析皖南医学院弋矶山医院神经外科2013年1月—2018年10月收治的42例侧脑室肿瘤患者的临床资料。其中经胼胝体前入路手术18例,经顶叶皮质入路16例,经额叶皮质入路4例,经颞叶皮质入路4例。结果本组患者中,肿瘤全切除者34例,次全切除6例,部分切除2例。术后出现颅内感染者4例、术区出血3例、继发性脑积水4例、视野变窄2例、短暂性失语1例、癫痫发作3例、偏瘫2例,经治疗后均有不同程度的好转。患者术后3个月的格拉斯哥预后量表(Glasgow outcome scale,GOS)评分,5分者35例、4分5例、3分2例,无死亡病例。结论侧脑室肿瘤常需外科手术干预,根据肿瘤的位置、大小、血供以及是否合并脑积水选择适当的手术入路;显微手术技巧的提升有助于减少患者术后的并发症。

Objective To explore the clinical features of the lateral ventricle tumor,the choice of surgical approach and the treatment of postoperative complications.To provide assistance for the diagnosis and treatment of lateral ventricle tumors.Methods The clinical data of 42 patients with lateral ventricle tumors admitted in Yijishan Hospital of Wannan Medical College from January 2013 to October 2018 were analyzed retrospectively.Of 42 patients,18 received anterior transcallosal approach,16 transa parietal cortical approach,4 transfrontal cortical approach,and 4 received transtemporal cortical approach.Results Total tumor resection was performed in 34 cases,subtotal resection in 6 and partial resection in 2.There were 4 cases of intracranial infection,3 of hemorrhage in the operation area,4 of secondary hydrocephalus,2 of narrow visual field,1 of transient aphasia,3 of seizure and 2 of hemiplegia.After treatment,they were improved to different degrees.Glasgow outcome scale(GOS)of 3 months after operation showed 5 points were 35 cases,4 points were 5,3 points were 2 and no case was dead.ConclusionsLateral ventricle tumors often require surgical intervention.Appropriate surgical approaches are selected based on tumor location,size,blood supply,and the presence of hydrocephalus.The improvement of microsurgical skills can help reduce the incidence of postoperative complications.