14例脑干海绵状血管瘤的显微手术治疗  

Microsurgical management of brainstem cavernomas

作　　者：陈忠智[1] 贾成武[1] 王运杰[2] 赖杰宇[1] 王仁春[1] 

机构地区：[1]解放军第二零二医院神经外科,沈阳110003 [2]中国医科大学附属第一医院神经外科

出　　处：《临床医学》2009年第2期1-3,共3页Clinical Medicine

摘　　要：目的探讨脑干海绵状血管瘤显微手术治疗的适应证及预后。方法对14例行显微手术治疗的脑干海绵状血管瘤患者的临床资料及手术效果进行分析总结。结果9例全切,4例次全切,其中1例于术后第3天再出血而死亡,另1例大部分切除。术后早期神经功能障碍改善6例,同术前5例,加重3例。随访6～38个月,仍有2例患者未恢复至术前状态。肿瘤未全切的4患者中有2例行放射治疗,肿瘤体积未见明确增大。肿瘤全切的9例患者生存良好,未见确切复发,亦无再次出血。结论对有手术指征的脑干海绵状血管瘤,积极行显微手术治疗效果良好。Objective To explore the outcome and indication of microsurgery in brainstem. Methods We retrospectively reviewed 14 patients diagnosed as brainstem cavernomas and treated by microsurgery from 2000 to 2007. All of the 12 patients underwent surgical resection of the tumor as the initial treatment. Their clinical manifestations and surgical outcomes were analyzed in order to evaluate the significance of microsurgery. Results Of the 14 brainstem cavernomas cases, total resection and sub - total resection was achieved in 9 and 4 cases, respectively. One case with the sub - total resection of the brain stem cavernomas suffered from re - bleeding of the tumor which happened three days after tumor resection and died the next day. Partial tumor resection was obtained in the left case. At the early stage, the post - operational nerve function was improved in 6 cases, kept the same level in 5 cases, and became worse in 3 cases. All patients were followed up for about 6 to 38 months, in which only 2 cases still did not recover to the preoperational state. The volume of the lension changed slightly in the 2 cases whose tumor was sub - totally dissected and took radiotherapy after operation. There was no recurrence and bleeding occurred to the 9 cases whose tumor was totally dissected and they survived well. Conclusion Satisfactory clinical outcome of microsurgery for brainstem cavernomas can be achieved if the indication for operation is obvious.

关 键 词：脑干 海绵状血管瘤 显微手术 

分 类 号：R651[医药卫生—外科学]