周良辅
中枢神经系统肿瘤、血管病变、先天性病变、外伤等诊治;微侵袭外科、导航外科、显微神经外科等技术研究和应用
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- 姓名:周良辅
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博士生导师
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外科学
- 研究兴趣:中枢神经系统肿瘤、血管病变、先天性病变、外伤等诊治;微侵袭外科、导航外科、显微神经外科等技术研究和应用
周良辅教授,男,1941年出生,神经外科教授。现任职务:上海神经外科临床医学中心主任、华山医院神经外科主任、上海市华山神经外科(集团)研究所所长、复旦大学神经病学研究所副所长、WHO神经科学研究和培训中心副主任、博士导师。全国政协委员(九、十届)、上海中华神经外科学会主任委员、中华神经外科学会副主任委员、复旦大学和上海市卫生局专科学术委员、国际神经外科联合会委员、欧亚神经外科学会委员。美国NEUROSURGERY、SURGICAL NEUROLOGY杂志国际编委、日本Neurologia Med. Chir国际编委、中国临床神经科学、微侵袭神经外科杂志等副主编、中华外科、中华显微外科、中华神经外科、中华创伤外科、上海医学、肿瘤和颅底与五官科杂志等编委。 1985年美国Minnesota 大学医院神经外科Fellow、Mayo Clinic,UCLA等访问教授。发表论文:200余篇。主要著作:主编现代神经外科学、神经外科手册、神经外科手术图解、神经外科鉴别诊断、颅底外科临床和基础和神经病学新技术和新理论等。参加编写显微外科、现代显微外科学、沈克非外科学、黄家驷外科学、实用神经病学、现代肿瘤学等。获奖:卫生部和中国医学论坛报杰出外科医生奖(1986)、上海市科学技术进步奖(1988、1993、1994、2001、2003、2004)、上海市医学科学技术进步奖(1997、1999、2003、2004)、卫生部科学技术进步奖(1989、1994、1996、1998)、国家教委科技进步奖(2002)和国家科学技术进步奖(1990、1995)、国家有贡献中青年专家(1988)、卫生部全国先进工作者(1994)、全国五一劳动勋章(1996)、上海市医学荣誉奖(1997)、光华医学奖(1998)、上海市优秀科技人才(2003)。全国科技图书一等奖(2004)。培养研究生:已培养博士生24人,硕士生12人,正在培养博士生8人,硕士生2人,博士后2人。专长和研究方向:中枢神经系统肿瘤、血管病变、先天性病变、外伤等诊治;微侵袭外科、导航外科、显微神经外科等技术研究和应用。
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周良辅
中华外科杂志,2002,82(4):217~218,-0001,():
-1年11月30日
Objective To investigate the best surgical approach to remove of trigeminal neurinomas (TNs). Methods 75 patients with TNs in Huashan Hospital were reviewed retrospectively. Results In early group (1978~1984) conventional intradural approaches were used, and in late group (1985~1995) an epidural approach via the skull-base craniotomy was utilized. Total removal of was achieved in 58%(20/35) in the early group and 80% (32/40)(P<0.05) in the late group. emporary or permanent cranial nerves morbidities were 62.7%, 37% in the early group and 28.1%, 10% (P<0.01) in the late group, respectively. Conclusions The best surgical approach with microsurgical technique for removal of TNs is epidural approach or epiduro-trans-duro-transtentorial approach via a skull-base craniotomy except the tumor only confined to the posterior fossa
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周良辅, 任力, 李世亭, 郭欢欢
中华外科杂志,1999,37(2):99~100,-0001,():
-1年11月30日
目的 探讨三叉神经鞘瘤最佳外科手术入路。方法 回顾性分析75例三叉神经鞘瘤的临床资料和随访结果。按时间先后分为早期组和后期组进行对比。结果 早期组(1978~1984年)应用常规硬脑膜内入路;后期组(1985~1995年)除颅后窝型应用枕下硬膜内入路外,均用颅底开颅硬脑膜外入路。早期和后期组肿瘤全切率分别为58(20/35)和80%(32/40)(P<0.05),暂时和永久颅神经障碍分别为63%,37%和28%,10%(P<0.01)。结论 除非肿瘤位于颅后窝,经颅底开颅硬膜外入路显微外科手术是切除三叉神经鞘瘤最好的方法。
神经鞘瘤 三叉神经
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【期刊论文】Intracranial epidermoid tumours: thirty-seven years of diagnosis and treatment
周良辅, LIANG-FU ZHOU
British Journal of Neurosurgery 1990, 4: 211-216,-0001,():
-1年11月30日
diagnosis rate was 13/22. Total tumor removal was achievedin 20 patients. Two of the 22 patients died after surgery, one of brain-stem injury and the other from an intracranial hemorrhage. Twenty patients were followed up for 2 months to 8 yeas (average, 2 years). Karnofsky scale months to 8 yeas (average, 2 years). Karnofsky scale was ≥80 in 15 patients, 60-70 in 1 patient and not measured in 4 patients who died during follow-up. The causes of death were pneumonia (2 patients) and purulent meningitis (2). Conclusion MRI and DSA (digital subtraction angiography) are major preoperative diagnostic modalities for PFSH, but PFSH remains a challenging benign neoplasm. Special microsurgical techniques and mproved operative manipulation can improve surgical efficacy.
Intracranial epidermoid tumour,, diagnosis treatment.,
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【期刊论文】Diagnosis and surgical treatment of posterior fossa solid hemangioblastomas
周良辅, ZHOU Langfu and DU Guhong
Chin Med J 2000; 113 (2): 129-132,-0001,():
-1年11月30日
rospectively, and a review of relevant literature was conducted. RESULTS These 20 cases accounted for 16.3% of all intracranial cavernous hemangiomas surgically treated in the same period at Huashan Hospital. The patients were aged from 32~69 years with an average age of 47 years. There were 17 females and 3 males. The common clinical manifestations were visual loss, diplopia, headache, facial numbness and extraocular muscle palsy. Computed tomography (CT) and magnetic resonance imaging (MRI) were major preoperative diagnostic modalities, but demonstrated nonspecific features. The preoperative misdiagnostic rate was 38.9%. Of the 20 patients undergoing craniotomy via modified pterional approach with or without orbitozygomatic osteotomy, tumors were removed through epidural approach (EDA) in 13 cases, intradural approach (IDA) in 7 cases. Hypotension was induced during the operation in 2 cases. Total tumor removal was achieved in 12 cases (92.3%) in the EDA group and nil in the IDA group. Incomplete tumor removal was 1 case (7.7%) in the EDA group and 7 cases (100%) in the IDA group. One patient in the IDA group died of intracranial hemorrhage postoperatively. Compared with preoperative manifestations, cranial neuropathies at discharge were worsened in 76.9% of patients in the EDA group and 83.3% of patients in the IDA group, improved in 15.4% of patients in the EDA group and 16.7% of patients in the IDA group, unchanged in 7.7% of patients in the EDA group. Follow-up study (range, 16 years; mean, 3 years) was available in 17 patients (89%). All patients in the EDA group improved without tumor recurrence. Nonimprovement (2 cases) and continued worsening (3 cases) occurred in the IDA group. In patients with tumor incompletely removed, the tumor enlarged in 2 cases, and unchanged or decreased in size in 3 cases, in which 2 cases underwent postoperative radiosurgery or radiotherapy. According to pathologic and MRI characteristics, the CSHs can be divided into two types, sponge-like type and mulberry-like type. CONCLUSION Cavernous hemangioma should be included in differential diagnosis for middle aged females with cavernous sinus tumors. Two types of the CSHs, sponge-like type and mulberry-like type, can be identified. The best microsurgical approach for the removal of the CSHs is epidural approach via the skull-base craniotomy. Radiosurgery should be considered for patients with incomplete tumor removal.
hemangioblastoma
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【期刊论文】Diagnosis and Surgical Treatment of Cavernous Sinus Hemangiomas: An Experience of 20 Cases
周良辅, Liang-Fu Zhou, M.D., Ying Mao, and Liang Chen
,-0001,():
-1年11月30日
From 1978 to 1988, 14 giant intracranial aneurysms (more than 2.4 cm in diameter) and one large aneurysm (1.5 cm in diameter) were treated by extracranial/intracranial (EC/IC) bypass or cerebral artery reconstruction. Of the aneurysms, 10 were located at the intracavernous carotid artery (CCA). One of the 10 anourysms was posttraumatic and located at both the carotid-ophthalmic artery segment and the bifurcation of the internal carotid artery (1CA). Three were seen at the middle cerebral artery (MCA) trunk. The aneurysms were demonstrated by angiography and CT scanning. They were treated with trapping of the aneurysm and superficial temporal artery (STA)/middle cerebral artery (STA-MCA) bypass with/without a graft (6 cases), cervical ICA !igation and STA-MCA bypass with/without a graft (6) aneurysm excision with an end-to-end anastomosis of the MCA and a STA-MCA bypass with a graft (1), proximal MCA occlusion and STA MCA bypass with a graft (1), and aneurysm neck clipping following a STA-MCA bypass with a graft (1). The patients showed marked improvement after operation except one whose neurological deficit was aggravated temporarily. Postoperative angiography revealed that the anastomoses were patent in all cases. No surgical mortality or any delayed ischemic complications were noted after follow-up for 5.6 years. We believe that cerebral artery reconstruction or EC/IC bypass is still effective in the treatment of large and giant intracranial aneurysms.
Cavernous sinus,, cavernous hemagioma,, surgery.,
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【期刊论文】CEREBRAL ARTERY RECONSTRUCTION IN THE TREATMENT OF LARGE AND GIANT INTRACRANIAL ANEURYSMS
周良辅, Zhou Liang-fu and Jiang Da-jie
Chinese Medical Journal 107 (1): 41-46, 1994,-0001,():
-1年11月30日
A modification of the transbasal approach of Dorome called extensive subfrontal approach and the surgical results with this approach in 22 cases are presented. Bilateral frontal craniotomies incorporated with the removal of orbital ridges and part of the orbital roofs were fashioned en bloc. It may give rise to good exposure of the midline lesions of the anterior, middle and posterior skull base, minimizing the need for the retraction of frontal lobes. There was no surgical mortality in this series of cases. Of the 20 cases with tumors, total resections were achieved in 11 cases, subtotal or large resections in 4 cases and partial resection in one case. Two patients with pontaneous rhinorrhea were successively treated surgically. 21 patients had a follow-up with a time ranging from 1-11 years (a mean of 3 years). 15 patients resumed their jobs with no evidence of recurrence of the original disease, and 5 patients able to live self-care. One patient with an olfactory neuroblastoma died 3 years after the operation owing to relapse of the tumor.
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【期刊论文】AN EXTENSIVE SUBFRONTAL APPROACH TO THE LESIONS INVOLVING THE SKULL BASE
周良辅, Zhou Liangfu, Guo Huanhuan, Li Shiqi, Ji Yaodong and Huang Fengping
Chinese Medical Journal 108 (6): 407-412, 1995,-0001,():
-1年11月30日
This paper deals with our experience in treating the 52 cases, with special reference to acupuncture anesthesia and the lateral suboccipital approach.
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【期刊论文】ACUPUNCTURE ANESTHESIA AND LATERAL SUBOCCIPITAL APPROACH FOR ACOUSTIC NEURINOMA EXTIRPATION
周良辅, Chen Gong baiand Zhou Liangfu
Chinese Medical Journal, 92 (12): 847-852, 1979,-0001,():
-1年11月30日
52 cases of acoustic neurinoma operated onduring the years 1973-1974 are reported. The results of operation performed under either general anesthesia or acupuncture anesthesia with 3 different approaches are analyzed and compared. The lateral suboccipital approach with acupuncture anesthesia is considered to be the method of choice for removal of this tumor. The technics for the 3 approaches are des-cribed in detail with illustrations. Since 1973, we have used both general anesthesia and acupuncture anesthesia with 3 different operative approaches for the removal of acoustic neurinoma. A com-parison of the results of 325 cases operatedon under general anesthesia from 1958 to 1972 and 52 cases operated on under general or acupuncture anesthesia from 1973 to 1974 revealed a striking difference in results. Although the complete extirpation rate of the 2 groups was about the same, being 60 and 65.4% respectively, the operative mor-tality rate was 13.2% in the former group and 5.8% in the latter and the corresponding figures for facial nerve preservation was less than 5% and 36.5%.
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