颅颈交界区肿瘤的显微外科治疗

目的提高颅颈交界区肿瘤显微手术治疗效果，减少手术并发症和改善术后生存质量。方法回顾性分析1990～2005年我院经显微手术治疗的30例颅颈交界区肿瘤的临床及影像学表现、显微手术方法和随访结果。结果本组神经鞘瘤全切率（7／8）；室管膜瘤全切率（5／8）；脑膜瘤全切率（4／6）；胶质瘤全切率（4／6），平均随访时间4．5年，神经鞘瘤、脑膜瘤恢复工作及生活自理者占（12／14），室管膜瘤（4／6），胶质瘤占（3／6）。结论术前MRI检查对颅颈交界区肿瘤的定性诊断及手术设计有重要的帮助，显微外科技巧是保证手术安全、减少术后并发症、获得良好疗效的关键。

Microsurgical treatment of tumors on craniocervical junction

Objective To improve the microsurgical outcome of tumors on craniocervical junction, reduce operative complications, and improve living quality. Methods The clinical manifestations, neuro-images, microsurgical methods and follow-up results were analyzed retrospectively in 30 cases ofcraniocervical tumors during 1990-2005. Results The total removal rates ofneurolemmoma, ependymoma, meningeoma and neurogliocytoma were 7/8, 5/8, 4/6 and 4/6 respectively. The average time of follow-up was 4.5 years. Twelve of the 14 patients of ependymoma and meningeoma had resumed their work and self-care ability, so had 4/6 ependymoma and 3/6 neurogliocytoma. Conclusion MRI examination is important for the diagnosis and operative design of craniocervical tumors. The skills of microsurgery are crucial for reducing the operative complications and achieving good surgical outcomes.