脊髓血管网状细胞瘤的显微外科治疗——附38例临床分析  

Microsurgical Treatment of Intramedullary Spinal Cord Hemangioblastomas:Report of 38 Cases

作　　者：李忠[1] 李学真[1] 刘磊[1] 杨宝[1] 刘藏[1] 杨俊[1] 王贵怀[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科,北京100050

出　　处：《中国神经肿瘤杂志》2007年第1期26-29,共4页Chinese Journal of Neuro-Oncology

摘　　要：背景与目的:脊髓血管网状细胞瘤诊断困难,且手术风险较高,本研究旨在探讨其诊断及显微外科治疗。方法:分析38例患者的MRI表现及其显微外科手术治疗的效果。结果:根据肿瘤在MRI及DSA上的表现可以确诊的病例均行肿瘤显微手术全切除术。术后患者神经系统症状好转者28例,8例无改善,2例加重。结论:MRI能对髓内血管网状细胞瘤作出诊断,而DSA则能帮助了解肿瘤血液供应情况,必要时可在术前先行栓塞,减少术中出血,降低手术风险,减少术后并发症。手术时应在显微镜下严格沿肿瘤界面进行分离,先离断动脉后处理静脉,尽量避免分块切除而力争整块全切,这是减少术中出血和避免神经功能损害的关键,术中电生理监测,对减少术中脊髓、神经损伤非常有帮助。BACKGROUND ＆ OBJECTIVE ：Hemangioblastomas ars rare intraspinal tumors. This study is to investigate the diagnosis and the microsurgical treatment of intramedullary spinal cord hemangioblastomas. METHODS： Thirty-eight patients with intramedullary spinal cord hemangioblastomas treated at Beijing Tiantan Hospital, from January of 2000 to April of 2005, were retrospectively analyzed. RESULT： Total resection was achieved in all the cases. Neurological conditions were improved in 28 patients, remained stable in 8 cases and deteriorated in 2 cases. CONCLUSIONS： MRI is the first choice for localization and identification of intramedullary spinal cord hemangioblastomas and DSA is more helpful in indicating blood supply of the tumors. Microsurgical total resection is the optimal method for the treatment. Operative methods varied with the different histological types of the tumors. It is most important that dissection is performed along the correct interface and the draining veins were well preserved devascularisation of the lessions. Intraoperative electrophysiological monitoring may reduce surgical lesions to spinal cord and nerves.

关 键 词：髓内肿瘤 血管网状细胞瘤 显微外科手术 

分 类 号：R739.41[医药卫生—肿瘤]