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目的 探索神经外科综合治疗位于视丘下部附近区域的囊性颅咽管瘤之方法。方法 选择 16例囊性或以囊性为主的颅咽管瘤 ,在CT介导立体定向内窥镜下切除部分囊壁或肿瘤实质 ,排除囊液减压后囊内置入Ommaya管 ,术后经反复抽吸囊液 ,并反复注入小剂量博来霉素 30～ 40次。结果 16例经治疗后视力、视野障碍明显好转 ,7例有颅内压增高者术后缓解。CT显示瘤腔缩小 ,无手术死亡 ,术后视丘下部功能紊乱反应轻。 14例获随访 2～ 3年 ,临床症状明显改善。结论 该疗法安全、简便、有效 ,是采用微侵袭神经外科手段治疗颅咽管瘤的有效方法 ,有一定的临床应用价值
Objective To explore a comprehensive method of neurosurgery in the treatment of cystic craniopharyngioma near the hypothalamus. Methods 16 cases of cystic or cystic craniopharyngiomas were selected. CT-guided stereotactic endoscopic resection of part of the cyst wall or tumor parenchyma, exclusion of cyst fluid decompression after the capsule into the Ommaya tube, postoperative After repeated suction of cyst fluid, and repeatedly injected a small dose of bleomycin 30 to 40 times. Results After treatment, 16 cases of visual acuity, visual field disorders improved significantly, 7 cases of intracranial pressure were relieved postoperatively. CT showed narrowing of the tumor cavity, no surgical death, postoperative hypothalamus dysfunction response to light. 14 cases were followed up for 2 to 3 years, clinical symptoms improved significantly. Conclusion The therapy is safe, simple and effective, and it is an effective method to treat craniopharyngioma with micro-invasive neurosurgery. It has certain clinical value