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目的探讨第四脑室肿瘤的显微手术的治疗方法。方法回顾性分析49例成人第四脑室肿瘤患者的临床资料,术中应根据肿瘤位置及其与四脑室粘连位置的不同,灵活运用不同的入路和方法进行分离和切除。肿瘤切除均在显微镜下操作。结果肿瘤全切除35例,次全切除13例,大部分切除1例。术后发生颅内感染3例,出现运动协调障碍1例。幕上远隔部位硬膜外血肿2例,皮下积液2例。术后因脑积水死亡1例。结论应用显微外科技术全切除第四脑室肿瘤,保护脑干功能,预防术后脑积水,有助于提高手术治疗效果。
Objective To investigate the treatment of microsurgery in the fourth ventricle tumor. Methods A retrospective analysis of 49 cases of adult patients with fourth ventricle of the clinical data, surgery should be based on the location of the tumor and the location of the fourth ventricle adhesions, flexible use of different approaches and methods for separation and resection. Tumor resections were performed under a microscope. Results Tumor resection in 35 cases, subtotal resection in 13 cases, most of the resection in 1 case. Postoperative intracranial infection occurred in 3 cases, 1 case of motor coordination disorders. The supratentorial site of epidural hematoma in 2 cases, subcutaneous fluid in 2 cases. A case of postoperative death due to hydrocephalus. Conclusion The microsurgical technique is the best method to remove the tumor of the fourth ventricle, protect the function of the brain stem and prevent postoperative hydrocephalus. It is helpful to improve the surgical treatment effect.