侧脑室三角区肿瘤显微手术治疗的初步临床分析

发布时间：2018-03-21 13:14

本文选题：侧脑室三角区　切入点：脑肿瘤　出处：《国际神经病学神经外科学杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的探讨不同手术入路显微镜下行侧脑室三角区肿瘤的手术治疗方法。方法对47例肿瘤位于侧脑室三角区并经显微手术治疗的患者相关资料进行回顾性分析,详细分析不同手术入路及术中操作技巧。结果 42例患者颅内肿瘤显微镜下全切,5例因肿瘤较大、界限不清部分切除,其中,2例胶质瘤和1例星型母细胞瘤部分切除+去骨瓣减压术,1例间变性室管膜瘤因肿瘤生长至对侧,部分切除术后复发;1例胶质肉瘤,出现迟发性术区出血,急诊行手术清除术区脑内血肿,第二天死亡。1例同侧术后出现硬膜外血肿,血肿量不多,未再次手术,经积极治疗逐渐吸收。5例患者术后合并颅内感染,行腰大池脑脊液持续引流,感染痊愈,预后良好。出院时GOS评分:39例预后评分5分,4例预后评分4分,1例评分3分,1例预后评分2分,2例评分1分。结论对于不同类型、不同生长方向的侧脑室三角区肿瘤,在影像导航系统指引下,选择合适的手术入路、不断提高手术技巧,可明显减少患者的功能损伤及手术并发症的出现,改善患者的预后。
[Abstract]:Objective to investigate the surgical treatment of lateral ventricular trigonometry tumors under different surgical approaches. Methods 47 patients with tumors located in the lateral ventricular trigonometry and treated by microsurgery were retrospectively analyzed. Results Total resection of intracranial tumors was performed in 5 cases under microscope because of large tumor size, and partial resection was not clear. Among them, 2 cases of glioma and 1 case of partial excision of astroblastoma, 1 case of anaplastic ependymoma grew to the opposite side because of tumor, and 1 case of gliosarcoma recurred after partial resection. The intracerebral hematoma was removed in the emergency operation area. On the second day, 1 cases died of epidural hematoma after ipsilateral operation. The amount of hematoma was not large, and the hematoma was not re-operated. After active treatment, 5 cases of postoperative intracranial infection were gradually absorbed. The infection was cured with continuous cerebrospinal fluid drainage from the cistern of the lumbar cistern, and the infection was cured and the prognosis was good. At discharge, the GOS score of 39 cases, the prognosis score of 4 cases, the prognosis score of 4 cases, the prognosis score of 4 cases, the prognosis score of 1 case, the prognosis score of 1 case, the score of 2 cases, the score of 2 cases, the score of 2 cases, the score of 2 cases. Under the guidance of image navigation system, the different growth direction of lateral ventricular trigonometry tumor, select the appropriate surgical approach, and improve the surgical skills, can significantly reduce the occurrence of functional injury and surgical complications, and improve the prognosis of patients.
【作者单位】：安徽医科大学附属省立医院神经外科脑功能与脑疾病省重点实验室;阜阳市第五人民医院神经外科;
【基金】：脑功能与脑疾病安徽省重点实验室绩效考核补助项目,编号:1506c085017,1606c08235
【分类号】：R739.41

【相似文献】