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find Author "范学政" 2 results
  • SKULL BASE RECONSTRUCTION AND PEROPERATIVE TREATMENT FOR CRANIO-ORBITAL TUMORS/

    Objective To investigate the peroperative treatment of cranio-orbital tumors and the method of the reconstruction of the skull base. Methods Between April 2008 and April 2011, 35 patients with cranio-orbital tumor were treated. There were 21 males and 14 females, aged 17-73 years (mean, 46.3 years). The first symptoms were orbital pain in 13 cases, hypopsia in 12 cases, exophthalmos or abnormal eye position in 5 cases, headache and dizziness in 2 cases, di plopia in 2cases, and pulsating eyeball in 1 case. Some of the patients needed resecting the zygomatic arch, supercil iary arch, and orbit roof. The autogenous bone, titanium net, frontal bone periosteum, biogel, and artificial meninges were used to reconstruct the skull base. Results Tumors were resected by one-stage operation, and the anterior skull bases were reconstructed. Postoperative MRI indicated that total removal of tumors was achieved in 30 cases, subtotal in 3 cases, and partial in 2 cases at 3 days. There was no operative death. Cerebrospinal rhinorrhea and infection occurred at 1 week in 1 and 2 cases respectively, and were cured after lumbar drainage and antibiotics. The patients were followed up 6 to 36 months (mean, 18 months). In patients having hypopsia, the visual function was improved in 9 cases at 1 month; in patients having orbital pain, pain rel ief was achieved at 2 weeks after operation; in patients having exophthalmos or abnormal eye position and pulsating eyeball, sympotoms disappeared after operation. In 27 patients with benign tumor, 24 were cured, without recurrence during follow-up; in 8 patients with mal ignant tumor, 6 had recurrence within 18 months and underwent second operation or radiotherapy, 2 relapsed cases died of cerebral hernia and respiratory circulating failure at 24 months after operation. No complication of enophthalmos, pulsating exophthalmos, or collapse of zygomatic region occurred. Conclusion Using the autogenous bone, titanium net, frontal bone periosteum, biogel, and artificial meninges to reconstruct the skull base has rel iable foundation, simple operation, and easy anatomical reconstruction, so it is an effective method after the removal of cranio-orbital tumors; better effectiveness would beobtained when combining with the peroperative nursing.

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
  • 显微血肿清除及去大骨瓣减压手术联合亚低温和腰大池引流治疗重症原发性脑出血

    目的 总结应用显微血肿清除及去大骨瓣减压手术联合亚低温和腰大池引流治疗重症原发性脑出血的临床效果。 方法 对2010年2月-2012年2月141例重症原发性脑出血患者,分别采用保守治疗(保守组32例)、常规开颅显微手术血肿清除治疗(对照组55例)及去大骨瓣显微手术联合亚低温及腰大池引流治疗(治疗组54例)三种方法进行治疗,并对3个月后的病死率及日常生活活动能力(ADL)进行比较分析。 结果 结果保守组32患者中死亡17例(病死率53.1%),对照组55例患者中死亡22例(病死率40.0%),治疗组54例患者中死亡19例(病死率35.2%),3组间患者病死率差异有统计学意义(P<0.05),治疗组的病死率明显低于保守组和对照组,差异均有统计学意义(P<0.05)。治疗组ADL分级1~3级患者明显多于保守组和对照组(P<0.01)。 结论 显微血肿清除及去大骨瓣减压手术联合亚低温和腰大池引流治疗重症原发性脑出血可以降低患者病死率低,提高患者生活质量。

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