显微外科治疗颅颈交界区病变54例分析

摘要

Objective To summarize the experience in microsurgical treatments of 54 cases with the lesions in craniocervical junction .Methods The data of 54 patients with the lesions in craniocervical junction were retrospectively analyzed .The clinical features ,surgical techniques and prognosis were summarized .Results All patients received microsurgical treatment ,of whom 35 cases were operated via post‐meso approach and 19 cases via far‐lateral suboccipital approach .Of 54 patients ,total resection was performed in 39 cases ,subtotal resection in 10 cases ,and partial resection in 5 cases .Glasgow outcome scale(GOS) showed favorable(4‐5 points) in 49 cases ,poor outcome (2‐3 points) in 4 cases and death(1 point) in one case .The patients were followed up 6 months later , which showed the satisfactory recovery in 53 cases .Conclusion On the basis of MRI examination before surgery , precise positioning and electrophysiological monitoring during operation , the microsurgeries of the lesions in craniocervical junction via suitable operation approach can be performed with good outcomes .%目的：总结54例颅颈交界区病变显微外科的治疗经验。方法回顾性分析54例颅颈交界区病变患者的临床资料，总结其临床特征、手术技巧及预后。结果54例患者均接受手术治疗；其中，经枕下后正中入路35例，远外侧入路19例。全切除39例，次全切除10例，部分切除5例。出院时按格拉斯哥预后评分（GOS），预后良好（4‐5分）49例，差（2‐3分）4例，死亡（1分）1例。术后6个月随访，全组临床症状均得到改善。结论依据术前M RI检查、术中精确定位与电生理监测，采取合适的手术入路，颅颈交界区病变显微外科手术治疗均可取得良好的效果。