1、囊性肿瘤是怎么引起的【显微外科手术治疗颅脑肿瘤的临床研究】 摘要 目的 探讨显微外科手术不同入路治疗颅脑肿瘤的临床途径和疗效分析。 方法 选取我院80例颅脑肿瘤患者，并根据其颅脑肿瘤病灶的部位不同分别采用不同手术入路行显微外科手术治疗，观察其临床疗效。 结果 本组80例颅脑肿瘤全切除74例，次全切除5例，大部切除1例；术后随访624个月均获良好预后，颅脑肿瘤原发临床症状基本消失，大部分患者均能够进行正常的学习和工作，无术后致残、生活不能自理等后遗症的发生；手术前后的生活质量评分差异有统计学意义（P 0.05）。 结论 显微外科手术治疗颅脑肿瘤应根据患者病灶的部位不同选择不同手术入路，能显著提高
2、显微外科手术的临床疗效，改善患者预后，提高患者术后生活质量。关键词 显微外科；不同入路；颅脑肿瘤中图分类号 R651.1 文献标识码 A 文章编号 1673-7210（x）07（a）-0038-02Clinical study of microsurgery in the treatment of craniocerebral tumorsMA Rujun1 ZHANG Wei1 LIU Yong1 YU Mingkun21.Department of Neurosurgery, the Eighty-Fifth Hospital of Peoples Liberation Army, Sha
3、nghai 200052, China; 2.Department of Neurosurgery, Shanghai Changzheng Hospital, Shanghai 200003, ChinaAbstract Objective To investigate the clinical pathways and curative effects of different approaches of microsurgery in the treatment of craniocerebral tumors. Methods 80 patients with craniocerebr
4、al tumors in our hospital were selected to receive different surgical approaches of microsurgical treatment according to the locations of lesions. Then the clinical curative effects were observed. Results Among the 80 patients with craniocerebral tumors, 74 patients received total resection, 5 patie
5、nts received subtotal resection and 1 patient received major resection. After the 6 to 24 months of postoperative follow-up, good prognosis was obtained for all: primary clinical symptoms of craniocerebral tumors disappeared; most patients were capable of normal learning and work. No postoperative d
6、isabling, life disenabling or other sequelae were observed. The preoperative and postoperative scores of life quality were significantly different (P 0.05). Conclusion Choosing different surgical approaches of microsurgery according to the locations of lesions in the treatment of craniocerebral tumo
7、rs can significantly enhance the clinical curative effects of microsurgery, improve prognosis of patients and promote postoperative life quality of patients.Key words Microsurgery; Different approaches; Craniocerebral tumors随着显微外科手术在颅脑肿瘤临床治疗中的广泛应用，有关其对颅脑肿瘤患者的手术安全性、肿瘤切除率、预后以及生活质量影响的研究不断增多，本研究回顾性分析我院x
8、x年诊治的80例颅脑肿瘤患者的临床资料，探讨显微外科手术不同入路治疗颅脑肿瘤的临床途径和疗效分析，寻找确实可行的提高颅脑肿瘤患者预后的治疗措施，并且为如何选择显微外科手术入路提供依据，现报道如下：1 资料与方法1.1 一般资料根据随机数字表法选取我院x年1月x年12月80例行显微神经外科手术治疗的颅脑肿瘤患者，其中，男47例，女33例，年龄2268岁，平均（42.47.8）岁。80例患者中病灶位于脑桥小脑角12例、岩斜区13例、鞍区9例、颅前窝底3例、第三脑室前部15例、丘脑-基底节区6例、蝶骨嵴5例、小脑10例、侧脑室4例、小脑幕3例。病例纳入标准包括颅脑肿瘤原发临床症状表现，如头痛、恶心呕吐、视乳头水肿或因肿瘤压迫引起的痛、麻、癫痫等局灶症状或内分泌症状，部分患者体征可见克氏征、布氏征、巴氏征和（或）昂伯征阳性；所有患者抽取脑脊液行实验室检查均可见蛋白升高、压力和白细胞数量升高；且经CT和MRI影像学检查均可发现患者病灶部位信号强度的改变。本研究中涉及患者均征得了患者本人或患者全权委托的家属的知情同意。
