摘要
目的：报道２４例颅底斜坡区表皮样囊肿的显微外科治疗，就其手术入路及肿瘤切除程度加以讨论。方法：分析了临床特点和ＣＴ、ＭＲＩ影像的特征性表现和特殊生长形状，深入分析其手术方法、手术结果和术后并发症等。结果：肿瘤全切除１５例，次全切除７例，大部切除２例，无手术死亡。术后有９例症状体征完全恢复。术后并发症以无菌性脑膜炎最多见，本组９例术后出现持续性高热及颈强直，经连续腰穿放脑脊液治疗后痊愈。可逆性颅神经功能障碍也常见，外展神经麻痹４例，后组颅神经麻痹３例，滑车神经及面神经麻痹各１例。术后迟发血肿４例。结论：颅底斜坡区表皮样囊肿手术选择颞枕经小脑幕入路和经桥小脑角（ＣＰＡ）入路是最常使用的手术入路。手术全切肿瘤及包膜可减少无菌性脑膜炎的发生。对减少术后迟发血肿的发生亦有裨益。
Objective: To report operations on 24 cases of epidermoid cysts centered on the clivus. Method: Clinical features, CT and MRI characteristics of the patients were studied. The operative approaches, results and complications were also disccused. Results: Total resection was achieved in 15 cases, no mortality of all. The main complications were chemical meningitis and delayed hemorrhage. Conclusion: Subtemporooccipital transtentorial approach and retrosigmoid approach are the main approaches for cyst resection. Tatal resections of the tumors could reduce the incidence of chemical meningitis delayed hemorrhage.
出处
《中华神经外科杂志》
CSCD
北大核心
1998年第1期41-44,共4页
Chinese Journal of Neurosurgery
