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目的结合笔者临床经验,探讨翼点入路切除鞍区肿瘤的方法。方法本组150例鞍区肿瘤,术前根据CT、MR及脑血管造影确定肿瘤与周围的关系,采用显微外科技术,经翼点入路手术,经4个不同的间隙切除肿瘤。结果本组94例全切,42例近全切,14例大部切除。近期明显好转103例,改善35例,无变化10例,死亡2例。半年以上随访109例,其中能正常工作(学习)68例,能做轻工作等22例,生活能自理10例,生活不能自理8例,死于心脏病1例。结论采用翼点入路多能满足鞍区不同类型肿瘤的显露,如结合翼点改良入路能提高鞍区肿瘤全切率及治愈率。
Objective To explore the method of pterional approach for resection of sellar tumors in combination with the author’s clinical experience. Methods The group of 150 cases of sellar tumors, preoperative CT, MR and cerebral angiography to determine the relationship between the tumor, the use of microsurgery techniques, pterional approach surgery, the tumor was removed through 4 different gaps. Results The group of 94 cases of complete resection, 42 cases near total resection, 14 cases of the majority of resection. The recent marked improvement in 103 cases, improvement in 35 cases, no change in 10 cases, 2 cases of death. More than half a year follow-up of 109 cases, of which 68 cases can work (learning), can do light work in 22 cases, life can take care of themselves in 10 cases, life can not take care of 8 cases, died of heart disease in 1 case. Conclusion The pterional approach can meet the different types of tumors in the sellar area, such as the improvement of the approach combined with the wing point can improve the total resection rate of the sellar area and the cure rate.