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    find Keyword "鞍底重建" 3 results
    • 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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    • 經鼻蝶入路的鞍底重建

      目的 探討經蝶手術利用神經補片及生物蛋白膠進行鞍底重建的效果。 方法 2005年1月-2009年5月對31例經鼻蝶手術術中鞍底重建資料進行回顧分析。腫瘤切除后,瘤床以全溶性止血纖維止血,鞍內以明膠海綿填塞,鞍底硬膜缺損使用神經補片適形修補,最外層以生物蛋白膠封閉。對于術中發生大量腦脊液漏及術后發生腦脊液漏的患者,術后輔以腰大池持續引流。 結果 術中少量腦脊液漏8例(25.81%),大量腦脊液漏3例(9.68%),平均腦脊液漏發生率35.49%;術中無明顯腦脊液漏20例及少量腦脊液漏8例;術后繼發腦脊液漏1例(3.23%)。術后腦脊液漏1例及術中大量腦脊液漏3例,輔以腰大池持續引流,5~7 d后腦脊液漏停止。無腦膜腦炎或視力下降等并發癥發生。 結論 利用神經補片結合生物蛋白膠進行鞍底重建能夠有效減少術后腦脊液漏。

      Release date:2016-09-08 09:47 Export PDF Favorites Scan
    • 經鼻蝶鞍區病變切除術后鞍底重建及圍手術期處理

      目的 總結經鼻蝶鞍區病變切除術后鞍底重建及圍手術期處理的相關經驗。 方法 回顧性分析2007 年10 月- 2008 年12 月收治的132 例經單鼻孔蝶竇入路行鞍區病變切除術患者鞍底重建及圍手術期處理方法。男64 例,女68 例;年齡19 ~ 74 歲,平均45.7 歲。病因:垂體無功能腺瘤91 例,生長激素腺瘤22 例,泌乳素腺瘤9 例,促腎上腺素皮質激素腺瘤2 例,促甲狀腺素釋放激素腺瘤1 例,Rathke 囊腫5 例,鞍內型顱咽管瘤2 例。術中采用由人工硬膜、顱骨和蝶竇黏膜組成的夾心層法重建鞍底。 結果 術后4 例發生少量腦脊液漏,給予腰大池持續引流1 周后治愈。術后再出血2 例,經藥物治療消退;術后高熱、感染3 例,經抗生素治療后2 例好轉,1 例配合腰穿持續引流后治愈。患者均獲隨訪,隨訪時間28 ~ 42 個月,平均35.2 個月。患者術前癥狀及體征術后不同程度好轉。 結論 以人工硬膜加自體骨片等材料為主體的鞍底重建技術具有解剖還原、操作簡便、穩固可靠、創傷小、無排斥等特點,輔以周全的圍手術期護理,能夠取得良好的重建效果。

      Release date:2016-08-31 05:44 Export PDF Favorites Scan
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