侧脑室内肿瘤的显微外科治疗附29例病例报告-外科学专业论文.docxVIP

— — PAGE 1— 摘 要 侧脑室内肿瘤的显微外科治疗（附29例病例报告） 研究生：买买江·阿不力孜 导师：柳琛 教授 摘 要 目的：侧脑室内肿瘤最佳的手术入路目前仍有争议，本文总结了按肿瘤起源决 定侧脑室内肿瘤手术治疗的策略和经验。方法：回顾性分析自2002年1月至2009年1 月在我院接受手术治疗的29例侧脑室内肿瘤病人的临床资料。14例病人采用经皮层 入路，15例病人采用经纵裂入路。结果：23例肿瘤全切除, 6例次全切除。86.20%病 人病理证实良性和低级别胶质瘤。65.51%病人得到良好的恢复，20.67%病人留下轻 微功能障碍。随访时间3个月～6年，平均2.3年，随访23例,失访5例,痊愈18例，复发3 例，肢体偏瘫无好转1例，1例转移瘤患者于术后4个月死于原发肿瘤（肺癌）。结论： 侧脑室内肿瘤病人准确选择手术入路可以得到良好的治疗效果。经纵裂胼胝体入路 是较理想的手术入路，但对于肿瘤较大或肿瘤向脑实质延伸者或继发性脑室内肿瘤 病人来说经皮层入路是较好的选择。肿瘤应争取全切, 但不可强求全切，残留部分可 进行放疗和/或化疗。 关键词：侧脑室; 肿瘤; 手术入路; 显微外科 新疆医科大学医学硕士学位论文 Microsurgical treatment of lateral ventricle tumors : A series of 29 cases Postgraduate: Maimaijiang.Abulizi Supervisor: Prof. Liu chen Abstract Objective: Optimal surgical management in lateral ventricle tumors remains controversial. We conducted a retrospective study of patients with these lesions treated with a surgical strategy on the basis of tumor origin. Methods: 29 consecutive patients underwent operation for lateral ventricle tumors at our hospital since 2002 year. The transcortical approach was used in 14 patients, and Transcallosal approach was used in 15 patients; Results :Total resection was performed in 23 patients,subtotal resection in 6 patients. 86.20 percent of tumors were benign and low-grade tumors.65.61% of patients achieved good recovery,and 20.67% patients still have moderate disability. Postoperative follow-up was performed from 3 months to 6 years, the mean follow-up period was 2.3 years.23 patients were followed ,5 cases were lost. 18 cases obtained full recovery, 3cases of recurrence ,one patient is still paralysis,one patient were died(because of lung cancer). Conclusion: Lateral ventricle tumors can be treated best by careful selection of the approach according to tumor origin and development. Overall, the transcallosal approach is preferred, but in patients with transependymal growth or large primary or secondary ventricular tumors, the transcortical is a better option. The tumors should be resected as totally as possible, but