本文選題：鞍區(qū) + 占位病變　； 參考：《天津醫(yī)科大學(xué)》2005年碩士論文

【摘要】：目的:總結(jié)758例鞍區(qū)占位病變的臨床資料,并結(jié)合對(duì)尸體頭顱標(biāo)本的鞍區(qū)顯微解剖研究,提高對(duì)鞍區(qū)解剖、鞍區(qū)手術(shù)和鞍區(qū)病變的認(rèn)識(shí)水平,用以指導(dǎo)和改進(jìn)臨床工作。 方法:一、回顧性分析758例鞍區(qū)占位病變的性別、年齡、臨床表現(xiàn)、影像學(xué)資料、病理特點(diǎn)、治療和術(shù)后并發(fā)癥情況,總結(jié)經(jīng)驗(yàn)教訓(xùn)。 二、利用CT對(duì)鞍區(qū)相關(guān)徑線(xiàn)進(jìn)行測(cè)量。借助手術(shù)顯微鏡對(duì)尸頭標(biāo)本進(jìn)行鞍區(qū)手術(shù)入路和鞍區(qū)顯微解剖的研究。 結(jié)果:本組758例鞍區(qū)病變,占同期顱內(nèi)占位病變的23.7%,共包括27種病變,其中垂體腺瘤544例(71.8%),顱咽管瘤69例(9.1%),腦膜瘤42例(5.5%),其他共103例(13.6%)。經(jīng)蝶手術(shù)是治療垂體瘤較好的選擇,翼點(diǎn)入路是治療鞍上病變的理想術(shù)式。鞍區(qū)解剖研究中,描述和測(cè)量了蝶鞍的相關(guān)徑線(xiàn)及鞍區(qū)顯微手術(shù)間隙。 結(jié)論:鞍區(qū)病變的發(fā)生率高,且種類(lèi)繁多、表現(xiàn)相似,臨床工作中容易誤診。通過(guò)總結(jié)分析,加強(qiáng)對(duì)該區(qū)域疾病的認(rèn)識(shí),提高術(shù)前確診率,有利于改善預(yù)后。鞍區(qū)所在部位深在,解剖結(jié)構(gòu)復(fù)雜,神經(jīng)、血管眾多且毗鄰許多重要結(jié)構(gòu),如垂體柄、下丘腦等。術(shù)者應(yīng)熟悉鞍區(qū)的顯微解剖,鞍區(qū)手術(shù)中,間隙Ⅰ、Ⅱ是最常用的間隙(間隙Ⅰ為視交叉前間隙;間隙Ⅱ?yàn)橐暽窠?jīng)、頸內(nèi)動(dòng)脈和大腦前動(dòng)脈間隙。);間隙Ⅲ、Ⅳ多配合間隙Ⅰ、Ⅱ來(lái)完成手術(shù)(間隙Ⅲ為頸內(nèi)動(dòng)脈、小腦幕游離緣間隙;間隙Ⅳ為打開(kāi)終板所得的間隙。),保護(hù)深穿支血管、下丘腦和垂體柄等是獲得良好療效的關(guān)鍵。
[Abstract]:Objective: to summarize the clinical data of 758 cases of Sella area occupying lesions, and to improve the understanding level of Sella region anatomy, Sella surgery and Sella area lesions, and to improve the clinical work. Methods: 1. The sex, age, clinical manifestation, imaging data, pathological features, treatment and postoperative complications of 758 patients with Sellar area occupying lesions were analyzed retrospectively. Second, CT was used to measure the relative diameter of Sellar region. The surgical approach and microanatomy of the cadaveric head were studied by means of surgical microscope. Results: there were 758 cases of Sellar lesions, accounting for 23.7% of intracranial space-occupying lesions in the same period. There were 27 kinds of lesions, including pituitary adenoma in 544 cases, craniopharyngioma in 69 cases, meningioma in 42 cases, and others in 103 cases. Transsphenoidal surgery is a better choice in the treatment of pituitary adenoma, and pterygoid approach is an ideal method for the treatment of suprasellar lesions. In the anatomical study of the Sellar region, the correlation diameters of Sella turcica and the microsurgical space in the Sellar region were described and measured. Conclusion: the incidence of Sellar lesions is high, and there are many kinds of Sellar lesions with similar manifestations, and it is easy to be misdiagnosed in clinical work. Through summing up and analyzing, it is helpful to improve the prognosis by strengthening the understanding of the disease in this area and raising the rate of preoperative diagnosis. The Sellar region is located deep, complex anatomical structure, numerous nerves and blood vessels, and adjacent to many important structures, such as pituitary stalk, hypothalamus and so on. The operation should be familiar with the microanatomy of the Sellar region. In the operation of the Sellar region, the space 鈪，

本文編號(hào)：1845673