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目的探讨开颅术后复发囊性颅咽管瘤的治疗方法。方法对我科13例复发囊性颅咽管瘤患者应用立体定向穿刺、Ommaya管置入反复抽吸囊液,配合32P内放疗治疗。术后长期随访观察疗效。结果在手术抽出囊液后,大多数患者临床症状和体征迅速改善。全部患者术后随访6～60个月,平均32.4个月。经影像学检查证实,术后囊腔消失、肿瘤无复发8例;肿瘤明显缩小、囊腔不足5ml者4例;1例多囊性肿瘤控制不理想,囊腔反复增大,多次门诊穿刺抽液,仅能控制症状。肿瘤总的有效控制率为92.3%。无手术相关死亡及严重并发症发生。结论联合应用立体定向Ommaya管置入反复抽吸囊液,配合32P内放疗的方法,可以安全有效的治疗复发囊性颅咽管瘤。
Objective To investigate the treatment of recurrent cystic craniopharyngioma after craniotomy. Methods Thirteen patients with recurrent cystic craniopharyngioma in our department were treated with stereotactic puncture. Ommaya tube was inserted into the aspirated cyst fluid repeatedly with 32P radiotherapy. Long-term follow-up after treatment. Results After surgical removal of cyst fluid, the clinical symptoms and signs of most patients improved rapidly. All patients were followed up for 6 to 60 months, an average of 32.4 months. Confirmed by imaging examination, the disappearance of postoperative cysts, no recurrence of the tumor in 8 cases; tumor was significantly reduced, less than 5ml cysts in 4 cases; 1 case of cystic tumor control is not ideal, repeatedly increased cysts, multiple outpatient puncture Suction, can only control the symptoms. The total effective tumor control rate was 92.3%. No surgery-related deaths and serious complications occurred. Conclusion Combined use of stereotactic Ommaya tube into the repeated aspiration of cystic fluid, with 32P radiotherapy method, safe and effective treatment of recurrent cystic craniopharyngiomas.