经翼点入路显微手术治疗鞍上型颅咽管瘤

目的探讨经翼点入路显微神经外科手术治疗鞍上型颅咽管瘤疗效及安全性。方法回顾性分析采用经翼点入路显微手术治疗的28例鞍上型颅咽管瘤患者的临床资料。结果全切除24例（86％），近全切除4例（14％）；术后并发症：尿崩症23例（有3例遗留永久性尿崩症），高热16例，血电解质紊乱26例，癫痫8例，意识障碍5例，应激性溃疡3例，垂体功能低下12例。1例术后死于高血钠。随访26例，随访时间12—58个月，能正常生活者22例，生活需要照顾者3例，视力、视野障碍者均有不同程度恢复，全切除病例随访期内未发现复发者。结论显微外科手术治疗鞍上型颅咽管瘤临床疗效较好，术中注意保护丘脑及各穿支动脉、滋养动脉，是减少术后并发症的关键。

Microsurgical removal of suprasellar craniopharyngioma via pterional approach

Objective To explore the microsurgical techniques for total removal of the suprasellar cranio pharyngiomas via the pterional approach.Methods The clinical data of 28 patients with suprasellar craniopharyngio mas resected by the microsurgery was analyzed retrospectively.Results The tumors were total removed in 24 cases (86%)and subtotal resected in 4 cases(14%).The frequent postoperative complications are diabetes insipidus,hy perthermy,imbalance of water and electrolyte and lower level of hormone.Conclusion It is the key to get fine operation effect that removal sclerotin of base of skull as far as possible and releasing cerebrospinal fluid sufficiently,paying attention to protect the perforating branch and nourishing artery in each operative spaces.