目的:探讨颅咽管瘤手术全切的方法及术后并发症的防治。方法:40例患者,其中36例经翼点入路,2例经额下入路,2例采用的是经鼻蝶入路。术后严密观测病人的意识、尿量和血清电解质,预防癫痫和激素替代治疗。结果:34例患者达到肿瘤全切除,4例次全切除,2例大部切除。术后24例患者出现多饮多尿;28例术后出现血钠水平异常;术后高热14例;3例抽搐;2例死亡。出院后随访1个月~5年,能正常参加日常工作或学习者33例,需生活照顾者4例,死亡1例。结论:选择合适的手术入路及术后密切观察,积极处理并发症,对提高肿瘤全切率及降低死亡率有十分重要的临床意义。 Objective: To explore the method of craniotomy and craniopharyngioma surgery and prevention and treatment of postoperative complications. Methods: Forty patients were enrolled in this study. Of them, 36 received pterional approach, 2 received frontal approach, and 2 received nasal approach. After careful observation of the patient’s awareness, urine output and serum electrolytes, prevention of epilepsy and hormone replacement therapy. Results: Totally resected tumor was achieved in 34 patients, subtotal resection in 4 patients, and partial resection in 2 patients. Twenty-four patients developed polyhydric polyuria after operation; 28 patients had abnormal serum sodium level after operation; 14 patients experienced hyperthermia; 3 patients twitched; and 2 patients died. Follow-up from 1 month to 5 years after discharge from the hospital, normal participation in daily work or learners 33 cases, 4 cases need life caregivers, 1 case of death. Conclusion: Choosing the appropriate surgical approach and close observation after operation, and actively treating the complications, are of great clinical significance for improving the rate of tumor resection and reducing the mortality rate.