颅脑手术戒毒这项新的医疗技术在社会上引起很大反响，最近被卫生部紧急叫停。从颅脑手术戒毒的历史、存在的 问题、哲学及伦理方面进行反思是有必要的。把一项临床科研项目直接变换成一项临床服务项目，既未经严格科学论证也不符合伦理与法规要求。

目的 探讨脑外伤患者发生迟发性尿崩症的诊断及治疗方法。方法 回顾性分析我科近5年脑外伤后发生迟发性尿崩症的19例患者。根据临床症状、实验室检查及头颅MRI检查早期明确迟发性尿崩症的诊断并给予及时处理。结果 所有患者的尿量均恢复正常，其中2例需终生服用12去氨基282右旋2精氨酸加压素（DDAVP）替代治疗。结论 脑外伤后迟发性尿崩症通过临床表现、实验室检查及头颅MRI检查明确诊断，行抗利尿激素制剂和口服的抗利尿药物治疗后效果满意。

目的 探讨桥小脑角大型及巨大型脑膜瘤手术入路及显微手术切除方法。方法 回顾分析经显微手术治疗的28例桥小脑角大型及巨大型脑膜瘤。其中19例采用枕下乙状窦后入路，3例采用颞枕开颅乙状窦前入路，4例采用颞枕开颅颞下小脑幕入路，2例采用颞枕开颅与幕上、下联合入路。结果 肿瘤全切除（SimpsonⅠ、Ⅱ级）22例，全切除率为7816%。全组无手术死亡。术后症状改善者20例，症状基本同术前5例。26例随访6个月至4年，生活自理者23例（8815%），复发2例（717%）。结论 合理选择手术入路，术中应用显微技术妥善处理和保护血管、神经、脑干等，能较理想地切除肿瘤和提高患者生存质量。

Objective: The object of this study was to analysis the therapeu-tic effects of microsurgical excision in cases with the large or giant cerebellopontine angle meningioma. Methods: We retro-spectively analyzed the 56 patients who suffered from the large or giant cerebellopontine angle meningioma and underwent the microsurgical therapy, for which the suboccipital-retrosigmoidal approach was adopted in 38 cases, the temporal-occipital cra-niotomy, presigmoidal approach in 6 cases, the temporal-occipi-tal craniotomy, inferotemporal tentorium cerebelli approach-ing cases, and the temporal-occipital craniotomy, supratentorial or infratentorial allied approach in 4 cases. Results: The tumors of 44 cases were all resected (Simpson 1, 11), with a total resection rate of 78.6%, and there was no operative mortality. After sur-gery, symptoms improved in 40 cases and remained unchanged in 10 cases. Among 54 cases, recrudescence was seen in 2 cases (3.7%) and being able to take care of themselves in 50 cases (92.6%) at 6 months through 6 years follow-up after surgery. Conclusion: A rationally selected surgical approach, a micro-scopic technology applied in the operation to appropriately treat and protect vein, nerve and brain stem, which can ideally excise the tumors, together can increase the survival ability of patients.

自1994年1月至2001年8月，我科采用显微外科手术治疗脊髓内肿瘤33例，疗效满意。现将报告分析如下。

目的 比较外伤性癫痫患者CT、MRI与脑电描记术（EEG）及经颅多普勒（TCD）的检查结果。方法 65例外伤性癫痫患者分别行CT、MRI及EEG、TCD检查，并对各种检测的结果进行比较。结果 EEG对外伤性癫痫病灶的检出阳性率最高，为78%（51/65），CT为42%（27/65），MRI为54%（27/50），TCD为62%（40/62）；病灶的定位率以MRI最高，为96%（26/27），CT为89%（24/27），EEG为57%（29/51）。CT及MRI与EEG检出的病灶部位符合率分别为52%（14/27）和63%（17/27）。结论 四种方法各有其优势，也有其不足，它们相互结合可以提高外伤性癫痫的正确诊断及病灶定位率。

Background: Lymphangioma of the soft tissue is not uncommon. However, as far as the authors know, intraspinal lymphangioma is clinically rare and very few cases have been reported previously. Methods: Two patients who had backache and acratia of the lower limbs and difficulty in relieving themselves were examined by plain radiography and magnetic resonance imaging before surgery. Treatment consisted of the usual technique of surgical resection of the tumor microscopically. Histological examination of the resected material confirmed the diagnosis. Postoperative follow-up assessment was performed by magnetic resonance imaging. Results: Intraspinal lymphangioma is very rare clinically and its cause remains controversial. Magnetic resonance imaging can obtain precise position fixing, but it is hard to make preoperative qualitative determination. The most effective treatment of intraspinal lymphangioma is to excise it totally. Conclusions: The clinical appearance of intraspinal lymphangioma has no character. Magnetic resonance imaging is important in diagnosing it. The most effective treatment of intraspinal lymphangioma is to excise it totally. Further observation is recommended because of the possibility of local recurrence.

目的 研究侧脑室脑膜瘤临床特点及显微外科手术治疗的效果。方法 利用CT、MRI及脑血管造影明确肿瘤的诊断，16 例侧脑室脑膜瘤均采用显微外科手术摘除。结果 本组病例肿瘤全部切除，无手术死亡。结论 CT、MRI是诊断侧脑室脑膜瘤最可靠的方法，血管造影明确肿瘤的供血情况，选择合理的手术入路应用显微外科手术可达到肿瘤的全切除。

目的 提高颅后窝血管网织细胞瘤的诊疗水平。方法 回顾总结31例颅后窝血管网织细胞瘤诊断方式及显微外科手术治疗效果。结果 31例肿瘤（囊性23例，实性8例），全切除30例（囊性23例，实性7例），次全切除1例（实性1例），术后神经功能明显改善27例（囊性23例，实性4例），加重3例（均为实性肿瘤），死亡1例（实性）。随访期间有3例复发（囊性1例，实性2例，其中1例实性为颈髓段再发）。结论 明确肿瘤解剖关系及血供情况，囊性肿瘤采用锁孔入路，实性肿瘤骨窗开颅，采用显微外科技术是提高疗效的重要方法。

回顾性总结分析22例巨大哑铃形椎管内肿瘤的治疗经验。22例肿瘤中获全切21例，次全切1例，无手术死亡。提出不同节段哑铃形椎管内肿瘤有其临床特点，早期诊断可提高疗效，MRI对其有确切定位及较好定性诊断，尽早实施显微手术及良好的术后护理，是获得手术成功的关键。