【摘要】目的：探讨大中型颅咽管瘤显微外科切除方法和术后并发症的防治。方法：术前测基础代谢率，激素替代疗法。手术主要采用翼点，应用显微外科技术从鞍区各个手术间隙分块切除。术后严密观测病人的意识，尿量和血清电解质，及时治疗。结果：病人显微镜下肿块全切11例，肿块少部分残留4例，发生尿崩症13例，发生电解质紊乱11例，发生体温失衡5例，死亡1例。结论：选择最合适的手术入路，熟悉充分利用鞍区各个解剖间隙是完成肿瘤全切的关键；术前采用激素替代疗法，术后积极处理并发症，可有效降低手术死亡率。

    【关键词】颅咽管瘤 术后并发症 显微外科技术

    Craniopharyngioma large and medium-sized Microsurgical treatment of

    He Qijun 1Zhao Jun 2Liu Jianyong 2Kang Tiejiang 2

    【Abstract】Objective: To investigate the large and medium-sized craniopharyngioma microsurgical removal methods and the prevention and treatment of postoperative complications. Methods: Preoperative measuring basal metabolic rate, hormone replacement therapy. Surgery used mainly wing, microsurgical Sellar region from the various technical gap block resection surgery. After closely observing the patient's consciousness, urine and serum electrolysis Quality, timely treatment. Results: All patients under the microscope mass cut in 11 cases, a small portion of residual tumor four cases occurred Diabetes insipidus 13 cases, 11 cases occurred electrolyte imbalance, the imbalance in the body temperature of five cases, one case of death. Conclusion: choose the most The appropriate surgical approach, and take full advantage of sellar region familiar with the anatomy of various tumor clearance is completed cutting all the key preoperative Using hormone replacement therapy, after active treatment complications, which can effectively reduce the mortality. ......