颅咽管瘤的显微外科治疗(附94例分析)

目的 探讨颅咽管瘤的显微手术治疗经验与技巧.方法 回顾性分析94例颅咽管瘤的显微手术方法、并发症和治疗结果,总结临床治疗过程中的体会.病人中男性居多,为58例（61.7%）.88例（93.6%）表现为神经系统及内分泌系统症状,最常见的症状为头痛,计75例（79.8%）.手术经扩大翼点入路71例,经额下入路19例,经半球间-纵裂入路2例,经蝶入路2例.结果 肿瘤全切除87例,次全切除4例,部分切除3例.最常见的术后并发症为垂体功能低下及尿崩.随访2～5年;正常工作生活84例,生活自理4例,生活需要照顾2例,死亡4例.结论 采用显微手术全切颅咽管瘤,效果良好.鞍区颅咽管瘤采用翼点入路是最佳选择.

Microsurgery for craniopharyngioma: analysis of 94 cases

Objective To investigate the experiences and skills of microsurgery for craniopharyngiomas. Methods The clinical data of 94 cases of craniopharyngiomas including operative approaches, complications and therapeutic results were analyzed retrospectively. The majority of cases were male (58 cases, 61.7%). Most of the patients (88 cases, 93.6%) presented with neurological symptoms, and headaches was the most common (75 cases, 79.8%). The operation was performed via a modified pterional approach in 71 cases, subfrontal approach in 19, transcollosal approach in 2, and transsphenoidal approach in 2. Results The tumor was totally removed in 87 cases,subtotal in 4, and partial in 3. The most common postoperative complications were panhypopituitarism and diabetes insipidus. Two to five years' follow-up was performed, 84 cases lived normal life, 4 had self-care capacity, 2 needed care for activities of daily living, and 4 died. Conclusion The total removal of craniopharyngiomas with microsurgical technique may achieve good therapeutic effect. Employing pterional approach may be the optimal way for total removal of craniopharyngiomas in the sellar region.