桥小脑角手术致同侧臂丛神经损伤的原因分析及预防

桥小脑角(cerebellopontine angle,CPA)手术属于神经显微外科的一个分支.这类手术时间长,体位放置一般为90°侧卧位.按照手术体位放置的原则,巡问护士在摆放90°体位时,往往会特别注意勿使处于身体下方的手臂受压和过度伸展,以防臂丛神经损伤,而实际操作过程中,手术同侧颈肩部之间被过度牵拉和上臂不正确的放置,同样也会造成臂丛神经损伤.

X-刀治疗颅内肿瘤115例研究

115 patients with intracranialtumor(128 nidus in total)have been treated by X－ knife made in china and 78 patients were followed－ up.The short－ term effect was satisfying. 1 Subject and method 1.1 Subject 115 patients ,78 male and 37 female,9 ～ 72 years old, diagnosis(by pathology or by image)was as follwing:24 metastatic encephaloma,48 glioma,19 meningioma,8 pituitary tumor,12 acoustic neurinoma and 4 pinealoma; the sizes of nidus: 10mm to 20mm(n=40), 21mm to 30mm(n=47), 31mm to 40mm(n=25),41mm to 48mm(n=16).The sites of nidus :52 in cerebral hemisphere,15 in saddle area,8 in basal ganglion,6 in clivus,10 in middle cranial fossa base,19 in cerebellum,7 in forth ventricle of cerebrum,11 in cerebellopontine angle.

X-刀治疗颅内疾病44例疗效分析

Objective to investigate therapeutic methods and effect of X-knife for on intracranial diseases. Method Recent effect of 44pqtients with cranial diseases by X-knife was observed. Radiological follow-up was performed on 40 cases with mean 5.65 months of followup time. Result 92.5% of tumors were controlled locally, stability and recovery rate was 90.0%. The local control of metastatic tumors of brain was higher, but most patients with metastatic tumors died of primary lesion. New metastatic lesions appeared in patients without panencephalic radiotherapy in 1～5months. Tumors of pineal region were sensitive to X-knife. Conclusion X-knife has a definite effect on intracranial diseases. For patients with tumors of pineal region complicated by serious hydrocephalus, shunting should be conducted before X-knife treatment. For patients with mild or morderate hydrocephalus, X-knife chould be utilized only under correct interventions such as dehydration. The local control rate of intracranial metastatic tumors was high, but survival time postoperation depended on panencephalic radiotherapy or control of primafry lision. For tumors with diameter＞ 3cm, pituitary tumors, brains stem tumors and tumors in cerebellopontine angle region repeated X-knife were suggested, which could improve cure rate and decrease complications.

In order to investigate the pathophysiologic mechanisms responsible for trauma-induced hearing disturbances due to auditory nerve degeneration, we established for the first time a rat experimental model in which auditory nerve degeneration due to compression injury of the cerebellopontine (CP) angle portion of the auditory nerve can be quantitatively evaluated. In this paper, Ⅰ demonstrate our clinical experience in CP angle surgery and some of the results of our experiments performed onthis rat experimental model. Trauma-induced hearing loss in CP angle operations has long been regarded as a sort of unavoidable "natural course"and therefore hopeless.I believe that this pessimistic view should be challenged and changed through new approaches in scientific research.