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find Keyword "鞍底重建" 3 results
  • 经鼻蝶鞍区病变切除术后鞍底重建及围手术期处理

    目的 总结经鼻蝶鞍区病变切除术后鞍底重建及围手术期处理的相关经验。 方法 回顾性分析2007 年10 月- 2008 年12 月收治的132 例经单鼻孔蝶窦入路行鞍区病变切除术患者鞍底重建及围手术期处理方法。男64 例,女68 例;年龄19 ~ 74 岁,平均45.7 岁。病因:垂体无功能腺瘤91 例,生长激素腺瘤22 例,泌乳素腺瘤9 例,促肾上腺素皮质激素腺瘤2 例,促甲状腺素释放激素腺瘤1 例,Rathke 囊肿5 例,鞍内型颅咽管瘤2 例。术中采用由人工硬膜、颅骨和蝶窦黏膜组成的夹心层法重建鞍底。 结果 术后4 例发生少量脑脊液漏,给予腰大池持续引流1 周后治愈。术后再出血2 例,经药物治疗消退;术后高热、感染3 例,经抗生素治疗后2 例好转,1 例配合腰穿持续引流后治愈。患者均获随访,随访时间28 ~ 42 个月,平均35.2 个月。患者术前症状及体征术后不同程度好转。 结论 以人工硬膜加自体骨片等材料为主体的鞍底重建技术具有解剖还原、操作简便、稳固可靠、创伤小、无排斥等特点,辅以周全的围手术期护理,能够取得良好的重建效果。

    Release date:2016-08-31 05:44 Export PDF Favorites Scan
  • 经鼻蝶入路的鞍底重建

    目的 探讨经蝶手术利用神经补片及生物蛋白胶进行鞍底重建的效果。 方法 2005年1月-2009年5月对31例经鼻蝶手术术中鞍底重建资料进行回顾分析。肿瘤切除后,瘤床以全溶性止血纤维止血,鞍内以明胶海绵填塞,鞍底硬膜缺损使用神经补片适形修补,最外层以生物蛋白胶封闭。对于术中发生大量脑脊液漏及术后发生脑脊液漏的患者,术后辅以腰大池持续引流。 结果 术中少量脑脊液漏8例(25.81%),大量脑脊液漏3例(9.68%),平均脑脊液漏发生率35.49%;术中无明显脑脊液漏20例及少量脑脊液漏8例;术后继发脑脊液漏1例(3.23%)。术后脑脊液漏1例及术中大量脑脊液漏3例,辅以腰大池持续引流,5~7 d后脑脊液漏停止。无脑膜脑炎或视力下降等并发症发生。 结论 利用神经补片结合生物蛋白胶进行鞍底重建能够有效减少术后脑脊液漏。

    Release date:2016-09-08 09:47 Export PDF Favorites Scan
  • USE OF ARTIFICIAL BONE OF TRICALCIUM PHOPHATE IN SELLAR FLOOR RECONSTRUCTION AFTER TRANSSPHENOIDAL MICROSURGERY FOR PITUITARY ADEOMA

    ObjectiveTo explore the effectiveness of the usage of artificial bone of tricalcium phophate in sellar floor reconstruction after transsphenoidal microsurgery for pituitary adeoma. MethodsBetween January and December 2014, 85 patients with pituitary adema underwent transsphenoidal microsurgery, and the clinical data were retrospectively analyzed. "Sandiwich" was used for sellar floor reconstruction in 46 cases (control group), and "sandiwich" combined with the artificial bone of tricalcium phophate in 39 cases (trial group). There was no significant difference in gender, age, disease duration, size of tumor, invasiveness, and the degree of damage to the sellar floor between 2 groups (P>0.05). ResultsTotal removal and subtotal removal of tumors were achieved in 39 cases and 7 cases of the control group, and in 33 cases and 6 cases of the trial group, showing no significant difference between 2 groups (Z=-1.303, P=0.193). Cerebrospinal leakage occurred in 8 cases of the control group and in 10 cases of the trial group during operation, showing no significant difference (Z=-1.748, P=0.080). The case number of cerebrospinal leakage in the control group (4 cases) was significantly more than that in the trial group (0) after operation (P=0.020). The time of gauze removal in the trial group (3 days) was significant shorter than that in the control group[(4.3±1.6) days] (t=2.236, P=0.033). The patients were followed up 3-14 months in the control group and 5-13 months in the trial group. No cerebrospinal leakage occurred during follow-up. ConclusionSellar floor reconstruction with artificial bone of tricalcium phophate is safe, and it can reduce cerebrospinal leakage and shorten the time of gauze removal.

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