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目的探讨手术切除松果体区肿瘤时对合并脑积水的处理。方法回顾性分析45例松果体区肿瘤合并脑积水病人的手术治疗,归纳经Poppen入路和经Krause入路切除肿瘤时对脑积水的处理办法。术后随访1￣10年,观察脑积水的转归情况。30例病人术前行脑室外引流术。病人均在切除肿瘤时行第三脑室脑池造瘘术。结果随访中10例因再发脑积水行脑室-腹腔分流术。统计学分析表明肿瘤不同切除程度者术后需行脑室-腹腔分流术的概率有显著性差异。结论脑积水的转归与肿瘤切除程度密切相关;尽可能切除肿瘤,彻底开放第三脑室与脑池的交通,是术中成功处理脑积水的关键。
Objective To investigate the surgical treatment of pineal region tumor with hydrocephalus. Methods A retrospective analysis of 45 cases of pineal tumor patients with hydrocephalus surgery, summarized by poppen approach and Krause approach to remove the tumor when the treatment of hydrocephalus. Follow-up 1 ~ 10 years after operation, observe the outcome of hydrocephalus. Thirty patients underwent preoperative ventricular drainage. Patients underwent resection of the tumor when the third ventricle cisternostomy. Results Follow-up in 10 cases of recurrent hydrocephalus ventricle - peritoneal shunt. Statistical analysis showed that there was a significant difference in the probability of ventricle-peritoneal shunt after different degrees of resection. Conclusions The prognosis of hydrocephalus is closely related to the degree of tumor resection. To remove the tumor as much as possible and thoroughly open the traffic between the third ventricle and the cisternal pool is the key to successful treatment of hydrocephalus during operation.