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目的 探索松果体区肿瘤全切除的可行性及技术要点。方法 回顾性分析该院 1986年 3月至 2 0 0 0年 5月收治并手术的 70例松果体区肿瘤患者的诊治及预后情况。结果 手术采用侧脑室入路 18例 ,Poppen入路 3 5例 ,Krause入路 17例 ;病理诊断胶质瘤 2 1例 ,生殖细胞瘤 14例 ,脑膜瘤 7例 ,畸胎瘤 7例 ,胆脂瘤 6例 ,胶质增生 4例 ,皮样囊肿 3例 ,脑膜囊肿 2例 ,蛛网膜囊肿 2例 ,脊索瘤、血管畸形、垂体腺瘤、Galen静脉瘤各 1例 ;肿瘤全切除 49( 70 % )例 ,次全切除 13( 18% )例 ,活检 8( 11% )例 ,其中 1995年以后 44例分别为 41例 ( 93 % )、3例 ( 7% )和 0例 ( 0 % )。全切除患者随访有 41例( 85 % )恢复良好。结论 松果体区肿瘤特别是良性肿瘤手术治疗效果良好 ,合理的手术入路及体位、娴熟的显微外科手术技巧是手术成功的关键。
Objective To explore the feasibility and technical points of total resection of tumors in pineal region. Methods A retrospective analysis of the hospital from March 1986 to 2000 surgery in 70 cases of pineal region tumor treatment and prognosis. Results There were 18 cases of lateral ventricle approach, 35 cases of Poppen approach and 17 cases of Krause approach. There were 21 cases of glioma, 14 cases of germ cell tumor, 7 cases of meningioma, 7 cases of teratoma, 6 cases of gliomas, 4 cases of glial hyperplasia, 3 cases of dermoid cysts, 2 cases of meningeal cysts, 2 cases of arachnoid cysts, chordoma, vascular malformations, pituitary adenomas, Galen’s aneurysm in 1 case; tumor resection 49 (93%), 3 (7%) and 0 (0%) patients after 1995, respectively ). Total follow-up of patients with follow-up in 41 cases (85%) recovered well. Conclusion The surgical treatment of tumors, especially benign tumors in the pineal region is effective, reasonable surgical approach and position, skilled microsurgery techniques are the key to successful operation.