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报导应用不同手术方法治疗282例颅咽管瘤的手术效果及远期疗效,介绍儿童组及成人组的临床特征。手术分:Ⅰ.活检组;Ⅱ.活检加放射治疗组;Ⅲ.肿瘤部分切除组;Ⅳ.肿瘤部分切除加放射治疗组;Ⅴ.肿瘤全切除组及Ⅵ,脑室大池引流术组。总手术死亡率为9.2％,Ⅰ、Ⅱ组为3.7％,Ⅲ、Ⅳ组为10.2％,Ⅴ组为26.3％。214例得到随访,其中120例存活,94例死亡;存活者中59例有肿瘤复发症状,70例参加工作、学习或生活自理,13例有生育能力。Ⅱ、Ⅲ、Ⅳ组5年生存率均较Ⅰ组高,Ⅳ组最高。全切除组平均存活已9年。提出手术方法选择,特别对儿童患者应力争肿瘤全切除,对有困难者尽量作肿瘤次全切除或大部切除,术后辅以放射治疗。并就肿瘤全切除手术入路等问题进行讨论。
Reported the application of different surgical treatment of 282 cases of craniopharyngioma surgical results and long-term efficacy, introduced the clinical features of children and adults. Surgical points: Ⅰ biopsy group; biopsy plus radiotherapy group; Ⅲ. Tumor resection group; Ⅳ. Tumor resection plus radiotherapy group; Ⅴ tumor resection group and Ⅵ, ventricular pool drainage group. The overall operative mortality was 9.2%, with 3.7% in groups I and II, 10.2% in groups III and IV and 26.3% in group V. 214 cases were followed up, of which 120 cases survived, 94 died; 59 survivors have tumor recurrence symptoms, 70 cases participate in work, study or living independently, 13 cases have fertility. The 5-year survival rates of group Ⅱ, Ⅲ and Ⅳ were higher than those of group Ⅰ, and group Ⅳ was the highest. The average survival of the resection group has been 9 years. Proposed surgical methods, in particular, children should strive to tumor resection, as far as possible for patients with subtotal tumor resection or partial removal, supplemented by radiotherapy. And the tumor resection surgery and other issues discussed.