颅咽管瘤的显微手术治疗

目的探讨颅咽管瘤显微手术治疗的方法和入路.方法回顾性分析32例颅咽管瘤显微手术的方法、并发症和治疗结果,总结临床处置过程中的体会.结果 31例患者经翼点入路、1例经前胼胝体入路完成手术.经术中观察及术后CT和MRI复查证实,肿瘤全切除26例,次全切除3例,部分切除2例.术后出现尿崩症24例,高钠高氯血症18例,低钠血症5例,高热11例.临床痊愈出院12例,好转出院19例,死亡1例. 结论采用显微手术全切颅咽管瘤,效果良好;术前即有明显下丘脑功能损害者,手术风险较大,预后差;鞍区颅咽管瘤采用翼点入路是最佳选择.

Microsurgical resection of craniopharyngiomas

Objective To investigate the method and approach of microsurgical resection of craniopharyngiomas .Methods The clinical data of 32 cases among the patients with craniopharyngiomas, who were hospitalized in our department from January, 1998 to June, 2004, were analyzed retrospectively.Results The operation was performed via a pterional approach in 31 cases and a transcallosal approach in 1 case. The tumor removal was considered total in 26 cases, subtotal in 3 cases, and partial in 2 cases. Twenty four cases were suffered from diabetes insipidus,18 cases from hypernatremia and hyperchloraemia, 5 cases from hyponatremia , and 11 cases from hyperpyrexia after operations. Twelve cases recovered clinically, 19 cases improved , and 1 case died. Conclusion The total removal of craniopharyngiomas may achieve good curative effect with microsurgical technique . The prognosis is poor and the operation risk is great if there is functional lesion of hypothalamus preoperation. Employing pterional approach may be the optimal way for total removal of craniopharyngiomas in sallar area.