远外侧入路切除枕大孔区肿瘤

首都医科大学学报 ›› 2005, Vol. 26 ›› Issue (4): 407-409.

远外侧入路切除枕大孔区肿瘤

葛明, 张俊廷, 贾桂军, 吴震, 崔勇, 齐巍

首都医科大学附属北京天坛医院神经外科

收稿日期:2005-06-30 修回日期:1900-01-01 出版日期:2005-08-24 发布日期:2005-08-24

Far Lateral Approach to Tumors of Foramen Magnum Regions

Ge Ming, Zhang Junting, Jia Guijun, Wu Zhen, Cui Yong, Qi Wei

Department of Neurosurgery, Beijing Tiantan Hospital, Capital University of Medical Sciences

Received:2005-06-30 Revised:1900-01-01 Online:2005-08-24 Published:2005-08-24

摘要/Abstract

摘要： 目的总结枕大孔区肿瘤的临床特点、治疗经验、远外侧入路的优点及显微手术技巧,以期进一步提高对枕大孔区肿瘤的诊断和治疗水平。方法回顾性分析1998年3月-2003年12月北京天坛医院神经外科采用远外侧入路治疗的92例枕大孔区肿瘤病例。结果全部病例均采用经远外侧入路显微外科手术切除肿瘤.肿瘤全部切除66例(71.7%);近全切除22例(23.9%);大部切除4例(4.3%).术后有41例病人出现并发症,发生率为44.6%.术后死亡2例,病死率2.17%。结论经远外侧入路显微神经外科手术可以直接显露下斜坡,暴露延髓颈髓腹侧,对脑神经提供良好的显露,易于控制椎动脉近端、远端及其分支,可以避免对脑干的牵拉,可以提高手术全切除率,降低手术损伤及术后并发症,使手术更加安全和成功.

关键词: 远外侧入路, 枕大孔区, 显微手术

Abstract: Objective To summary the clinical characters of foramen magnum tumors, discuss the surgical approach and microsurgical skill for improving the ability of diagnosis and treatment of tumors in formen magnum.Methods By analyzing retrospectively 92 cases of foramen magnum tumors resected by the far-lateral approach in department of neurosurgery in Beijng Tiantan Hospital from March 1998 to December 2003.Results All cases adapted the far-lateral approach and microsurgical techniques. In all of 92 cases, total removal was achieved in 66 cases (71.7%); 22 (23.9%) case were resected subtotally and 4 (4.3%) cases were resected partially. Post-operative complications were confirmed in 41 cases (44.6%), 2 case died after operation and surgical mortality was about 2.17%.Conclusion Lower clivus, ventral medullar, lower cranial nerves can be exposed by farlateral approach. The injures of artery, nerve fibers and brainstem in operation can be decreased or avoided by this approach.

Key words: far lateral approach, foramen magnum, microsurgery

中图分类号:

R739.41

葛明;张俊廷;贾桂军;吴震;崔勇;齐巍. 远外侧入路切除枕大孔区肿瘤[J]. 首都医科大学学报, 2005, 26(4): 407-409.

Ge Ming;Zhang Junting;Jia Guijun;Wu Zhen;Cui Yong;Qi Wei. Far Lateral Approach to Tumors of Foramen Magnum Regions[J]. Journal of Capital Medical University, 2005, 26(4): 407-409.

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