Poppen入路切除天幕裂孔附近病变初步探讨

Clinical effect of resection of lesions in the tentorial region via the Poppen approach

摘要:

目的 探讨Poppen入路切除天幕裂孔附近病变的疗效。方法 回顾性分析12例患者采用Poppen入路切除天幕裂孔附近病变的临床资料，治疗过程，疗效。分析患者病灶全切除率并发症的发生率，以及对患者术前与术后早期的KPS评分进行统计学分析。结果 10例患者病灶得到全切，2例次全切除，术后未见明显的脑功能损害加重表现，手术并发症发生率为0。患者的症状明显改善，术后早期KPS评分改善，术后早期都>80分，术前与术后早期的KPS评分存在统计学差异，术后生活质量明显提高，均能生活自理。结论 选择Poppen入路切除天幕裂孔附近病变是安全、有效的，该入路手术视野宽敞，能在直视下操作，距离短；减少对重要静脉血管，静脉窦的损伤；减少对脑组织牵拉，降低脑组织的副损伤。能改善患者术后的生活质量。

Abstract:

Objective To evaluate the clinical effect of resection of the lesions in the tentorial region via the Poppen approach.Methods A retrospective analysis was performed for the clinical data of 12 patients who underwent resection of the lesions in the tentorial region via the Poppen approach, including treatment process and treatment outcome. A statistical analysis was performed for total resection rate, the incidence rate of complications, and Karnofsky Performance Scale (KPS) scores before surgery and early after surgery.Results Of all patients, 10 achieved total resection of lesions and 2 achieved subtotal resection. There was no marked aggravation in brain function impairment after surgery, and no surgical complications were observed. All patients had significant improvements in symptoms and KPS score in the early stage after surgery (KPS score >80). There was a significant change in KPS score early after surgery. There was also a significant improvement in quality of life, and all the patients were able to take care of themselves.Conclusions Resection of the lesions in the tentorial region via the Poppen approach is safe and effective. It can provide a wide field of view and operation can be done under a direct view with a short distance. It can reduce the injury of important veins and venous sinus and the traction of brain tissue to reduce subsidiary injury. It can also improve patients' quality of life after surgery.