听神经瘤显微手术中岩静脉的保护

目的探讨显微手术切除听神经瘤时岩静脉保护的方法和临床意义。方法显微手术治疗听神经瘤147例,术中先行肿瘤内减压,再逐步分离肿瘤周边结构。岩静脉143例保护良好;4例术中被切断行电凝处理。结果 143例患者术后未发生小脑出血性梗塞。4例电凝处理岩静脉,其中1例发生一过性广泛性小脑水肿,随访18个月能生活自理,但仍有走路步态不稳,3例出现小脑出血性梗塞并水肿,其中1例死亡;2例经后颅窝减压后恢复良好,其中1例随访3 3个月无明显神经功能障碍,1例随访1 2个月尚有走一字路不稳。结论在听神经瘤显微手术中应保护好岩静脉,一旦损伤需在手术后密切观察病情变化,做好再次后颅窝减压手术的准备。

The preservation of petrosal vein in operative cases of acoustic neuroma

Objective To discuss the preservation of petrosal vein and its clinical significance in the microsurgical operation of acoustic neuroma.Methods 147 patients with acoustic neuroma were operated,with internal decompression of the tumor firstly then dissected the tumor from surrounding structures.The petrosal vein was protected well in 143 cases and failed in 4 cases.Results No cerebellar hemorrhagic infarction was observed in 143 cases and the petrosal vein was preserved.One case occurred with extensive cereb...