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目的 介绍松果体区大脑深静脉系统所形成的自然间隙的显微外科解剖与不同手术入路治疗松果体区肿瘤的疗效与体会。 方法 在 2 0例尸体头标本上模拟Poppen及Krause入路进行松果体区大脑深静脉系统的显微解剖研究 ,并对显微外科手术治疗的 3 5例进行回顾性分析 ,对两种手术入路的静脉间隙进行较详细的比较与探讨。 结果 显微外科解剖研究与临床应用相结合使松果体区肿瘤的手术入路更趋于完善。Poppen入路 2 4例 ,Krause入路 11例 ,其中全切除 2 2例 ,次全切除 7例 ,部分切除 6例。无手术死亡。术后随访 3个月～ 3年 ,均正常生活。 结论 松果体区静脉系统是阻碍手术操作的主要结构 ,松果体区手术有 4个由大脑深静脉系统所构成的显微解剖间隙 ,手术入路的选择结合显微解剖研究 ,是松果体区肿瘤全切除的关键所在。
Objective To introduce the microsurgical anatomy of the natural gap formed by the deep venous system of the brain in the pineal region and the effects and experiences of different surgical approaches in the treatment of tumors in the pineal region. Methods Microscopic anatomy of the deep venous system of the brain in the pineal region was simulated on Popcorn and Krause in 20 specimens of cadaver heads and retrospectively analyzed 35 cases treated by microsurgery. Into the venous gap for more detailed comparison and discussion. Results The combination of microsurgical anatomy and clinical application made the surgical approach of pineal region tumors more perfect. There were 24 cases of Poppen approach and 11 cases of Krause approach, including 22 cases of total resection, 7 cases of subtotal resection and 6 cases of partial resection. No surgery died. Follow-up 3 months to 3 years, all normal life. Conclusions The pineal region venous system is the main structure impeding the operation. There are four microsurgical dissection spaces in the pineal region surgery, which are composed of the deep venous system of the brain. The choice of surgical approach combined with microanatomical study is the result of pineal Body tumor removal of the key.