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目的脑干及毗邻部位肿瘤进行根治性切除有时十分困难 ,据MRI检查所见肿瘤位置和生长方式选择相应手术入路 ,注重术中操作及术后管理 ,使这些肿瘤切除成为可能并可降低死亡率。方法所有此类患者均作CT、MRI,必要时做DSA。我科对11例脑干及毗邻部位肿瘤患者根据肿瘤不同位置和生长方式 ,选择了手术入路、手术方式和术后治疗。结果显微镜下全切除4例 ,次全切除3例 ,肉眼下全切除2例 ,大部切除2例 ,术后需要用呼吸机5例 ,无手术死亡。结论严格地选择手术入路是切除肿瘤的关键 ,其优点是显露满意 ,可尽量减少牵拉周围脑组织 ,直视下操作避免损伤正常组织 ,减少并发症 ,术后呼吸机的合理应用可直接减少死亡率。
Objective Radical resection of the brain stem and adjacent tumor is sometimes very difficult, according to the MRI examination of the tumor location and growth pattern to select the appropriate surgical approach, focusing on intraoperative management and postoperative management, so that these tumor resections possible and reduce death rate. Methods All patients underwent CT, MRI and DSA if necessary. Our department of 11 cases of brain stem and adjacent parts of the tumor patients according to tumor location and growth patterns, choose the surgical approach, surgical methods and postoperative treatment. Results Under the microscope, total resection in 4 cases, subtotal resection in 3 cases, total resection in 2 cases and partial resection in 2 cases. Postoperative need of ventilator in 5 cases, no operative death. Conclusion Strict selection of the surgical approach is the key to tumor removal. The advantage of this method is to reveal the satisfaction, minimize the pulling of the surrounding brain tissue, avoid the normal tissue damage under direct vision, and reduce the complications. The reasonable application of the ventilator can be directly Reduce mortality.