目的：探讨显微手术治疗第四脑室肿瘤的临床效果。方法分析2011年1月—2013年12月海南医学院附属医院收治的行显微手术的第四脑室肿瘤35例的临床资料,总结治疗经验。结果35例均行显微手术,8例采用小脑下蚓部入路,23例采用小脑延髓裂入路,4例采用联合入路；病变全切除32例,次全切除3例；术后病理检查显示髓母细胞瘤15例,室管膜瘤10例,血管母细胞瘤及星形胶质细胞瘤各3例,脉络层乳头瘤2例,胶质母细胞瘤和脑膜瘤各1例。术后头晕、步态不稳及脑积水等均有明显改善。术后6个月,卡氏功能状态标准评分60分2例,70分9例,80分17例,90分6例,100分1例。32例术后随访6~36个月,27例生活正常,5例复发(其中2例死亡)；3例失访。结论恰当选择手术入路、良好手术技巧及正确处理并发症是增强显微手术治疗第四脑室肿瘤效果的重要因素。%Objective To investigate the clinical effect of microsurgical treatment of the fourth ventricular tumors. Methods Clinical data of 35 cases of fourth ventricle tumors operated on in Affiliated Hospital of Hainan Medical College from January 2011 to December 2013 were analyzed retrospectively. The treatment experience was summarize. Results All the patients underwent microsurgery. 8 patients were operated on by cerebellar vermis approach and 23 patients were operated on by cerebella medulla oblongata approach, and the others by combination approach;32 cases underwent total resection and 3 cases underwent subtotal resection; postoperative pathological examination showed medulloblastoma (15 cases), ependy-moma(10 cases), hemangioblastoma(3 cases), star cutin cell tumor (3 cases), choroid layer papilloma (2 cases), cutin mother cell tumors (1 case) and meningiomas (1 case). Hydrocephalus, dizziness, ataxia symptoms were improved after op-eration. KPS was used to evaluate the patients' situation 6 months after operation; 2 cases with 60 scores, 9 cases with 70 scores, 17 cases with 80 scores, 6 cases with 90 scores, 1 case with 100 scores. A 3-36 month follow-up of 32 cases showed that 27 case were good recovery, 5 cases were relapse (2 cases of mortality);3 cases were lost in follow-upsConclusion Proper operative approaches together with microsurgical skills and proper treatment of complications are the key to improving treatment effect of microsurgery for the fourth ventricular tumors .
展开▼
