經(jīng)眉弓鎖孔入路治療顱內(nèi)病變（附290例分析）

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1、經(jīng)眉弓鎖孔入路治療顱內(nèi)病變(附290例分析)作者：鄭永口單位:華中科技大學(xué)同濟(jì)醫(yī)學(xué)院，湖北武漢430030【摘要】目的總結(jié)經(jīng)眉弓鎖孔入路治療顱內(nèi)病變的手術(shù)經(jīng)驗(yàn)。方法冋顧性分析近10年來(lái)收治的290例顱內(nèi)病變的手術(shù)經(jīng)驗(yàn)。病變位于鞍區(qū)279例，顱前窩9例，第三腦室2例。均行經(jīng)眉弓鎖孔入路病變切除術(shù)。結(jié)果病變?nèi)谐?14例(73.8%),次全切除76例(26.2%)O206例術(shù)前視力障礙病人中，術(shù)后1周內(nèi)視力有所改善158例(76.7%)。術(shù)后出現(xiàn)暫時(shí)性尿崩24例(8.3%)；腦脊液鼻漏5例(1.7%),經(jīng)保守治療后恢復(fù)。107例功能性腺瘤病人中，術(shù)后1周內(nèi)分泌恢復(fù)

2、止常水平56例(52.3%),其余均有不同程度的下降。1例無(wú)功能垂體腺瘤病人術(shù)后第5天死于心肌梗死。對(duì)180例病人術(shù)后隨訪1年，復(fù)發(fā)15例。結(jié)論經(jīng)眉弓鎖孔手術(shù)是一種安全、有效的微創(chuàng)手術(shù)，值得進(jìn)行深入研究和廣泛應(yīng)用。【關(guān)鍵詞】經(jīng)眉弓鎖孔入路腦腫瘤顯微外科手術(shù)Transorbitalkeyholeapproachforintracranialdiseases:analysisof290casesZHENGYongri1,GUOMian2,LIQingsong2,etal.1.TongjiMedicalCollege,HuazhongUniversityofScie

3、nces&Technology,Wuhan430030,China;2.DepaitmentofNeurosurgery,SecondAffiliatedHospitalofHarbinMedicalUniversity,Harbin150086,ChinaAbstract:ObjectiveTosummarizeoperativeexperienceviaTransorbitalkeyholeapproachforintracranialdiseases.MethodsSurgicalexperieneefrom290patientswithintr

4、acranialdiseasesoperatedinthepast10yearswereretrospectivelyanalyzed?Thetumorwaslocatedinsellarin279cases,formerfossain9,andthethirdventriclein2.Patientswerealloperatedonthroughthesupraorbitalkeyholeapproach?ResultsTotalresectionoftumorwasachievedin214cases(73.8%),andsubtotalin76(26.

5、2%).In206patientswithpreoperativevisualimpairment,158(76.7%)obtainedvisualimprovement1weekaftertheoperation.Temporarydiabetesinsipidusoccurredin24(8.3%)casesandcerebrospinalfluidfistula,recoveredafterconservativetreatment,in5(1.7%).In107patientswithfunctionaladenoma,endocrinehadreco

6、veredtonormallevelinoneweekin56(52.3%)cases,andtheresthadvaryingdegreesofdecline.Onecaseofnon-functioningpituitaiyadenomadiedofmyocardialinfarctionatday5afterthesurgery.Onehundredandeightypatientswerefollowedupfor1yearwithrecurrencein15.ConclusionThesurgeryviasupraorbitalkeyholeappr

7、oachisasafeandeffectiveminimallyinvasiveoperation,thusdeservingfurtherstudyandwiderapplication?Keywords:transorbitalkeyholeapproach;brainneoplasms;microsurgery1998年9月~2008年1月，我科采用經(jīng)眉弓鎖孔入路治療顱內(nèi)病變290例，手術(shù)創(chuàng)傷小，病變?nèi)新矢撸∪嘶謴?fù)快，取得了良好的療效，現(xiàn)報(bào)告如下。1對(duì)象與方法1.1一般資料男性130例，女性160例;年齡6?78歲,平均36.8歲。病程1周?18年,

8、平均10個(gè)月。其中單眼視力下降110例