锁孔手术理念在处理颅底和脑深部病变中的应用(附49例报告)

目的 探讨对锁孔神经外科手术的认识和经验。方法 对49例颅底或脑深部病变行中小骨窗开颅显微外科手术病变切除术，其中部分病例使用神经内镜和神经导航技术。结果 44例实体瘤全切除22例，次全切除18例。无手术死亡和致残，无术后症状加重，手术输血平均175ml。结论 锁孔手术是一种处理脑深部或颅底病变的微创神经外科技术，恰当的适应证选择，娴熟的显微手术技巧和必要的手术设备(如神经内镜、神经导航)可以提高显微手术效果，减少手术创伤。

Treatment of lesions located in depth of brain or skull base by keyhole concept (report of 49 cases)

Objective To summarize the experience of keyhole operation. Methods 49 cases of lesions located in depth of brain or in skull base were treated by microsugical craniotomy with middle-small bone flap, and some of these were trea ted with endoscope-assisted microsugery or neuronavigation. Results 22 cases o f solid tumors were totally removed, and 18 cases subtotally removed. There was no associated morbidity, mortality or exacerbation in all cases. The mean volume of blood transfusion was 175 ml. Conclusion Keyhole operation is a strategy o f minimally invasive neurosurgery to deal with the lesions in depth of brain or skull base. However, it is necessary to choose indication properly, to operate w ith proficient skill of microsurgery, and to equip the essential apparatus for o peration, such as endoscope and neuronavigator.