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【目的】探讨经额下-纵裂联合入路显微手术切除巨大鞍区肿瘤的方法、疗效及适应证。【方法】1996年1月至2004年12月,作者采用经额下-纵裂联合入路切除26例最大径超过4 cm的鞍区肿瘤,其中脑膜瘤13例,垂体腺瘤8例,颅咽管瘤5例。【结果】本组肿瘤全切24例,次全切2例,全切率91.7%,术后无死亡及严重并发症,平均KPS计分88.5。【结论】应用经额下-纵裂联合入路可提高鞍区巨大肿瘤全切率,减少并发症;适应于肿瘤最大径>4 cm),正中生长,质地硬,与wills环关系密切,尤其是大脑前动脉、前交通动脉穿过肿瘤者。
【Objective】 To explore the method, curative effect and indications for the microsurgical resection of the giant sellar tumor by the combined approach of the inferior-longitudinal splitting approach. 【Methods】 From January 1996 to December 2004, 26 patients with sellar region more than 4 cm in diameter were excised via the combined approach of inferior frontal-longitudinal incision, of which 13 were meningioma, 8 were pituitary adenoma, Pharyngotumor in 5 cases. 【Results】 Totally 24 cases were completely excised, 2 cases were subtotectically resected, and the total resection rate was 91.7%. There was no death and serious complications after operation. The average KPS score was 88.5. 【Conclusion】 The application of combined prefrontal-longitudinal combined approach can improve the total resection rate of the huge tumor in the sellar region and reduce the complications. It is suitable for the largest diameter of the tumor> 4 cm. It grows in the middle with hard texture and is closely related to the wills, Is the anterior cerebral artery, anterior communicating artery through the tumor.