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。