丘脑海绵状血管畸形的手术治疗及预后  

Surgical treatment and prognosis of thalamic cavernous mafformation

作　　者：李达[1] 吴震[1] 郝淑煜[1] 汤劼[1] 肖新如[1] 张力伟[1] 张俊廷[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科,100050

出　　处：《中华神经外科杂志》2012年第1期33-37,共5页Chinese Journal of Neurosurgery

基　　金：首都医学发展科研基金（2007-2064）

摘　　要：目的 探讨丘脑海绵状血管畸形的手术治疗及预后.方法 对27例手术治疗的丘脑海绵状血管畸形的临床资料进行回顾性分析并随访评价.结果 27例患者共出血48次,术前KPS评分为（64.1±9.7）分.经三角区入路18例,胼胝体入路4例,其他入路5例.病灶全切26例,近全切1例.平均随访（48.7±43.2）个月,肢体力弱（53％）、肢体麻木（61％）、行走困难（25％）和视力（67％）等症状较术前改善,而言语表达无明显改善.随访KPS评分为（81.1±15.8）分,其中22例改善,5例稳定.术前KPS评分＞70分（P=0.04）和女性（P=0.028）与预后显著相关.结论 手术治疗丘脑海绵状血管畸形可取得良好预后.Objective The goal of this study was to retrospectively analyze the natural history of thalamic cavernomas and outcome after surgical resection.Method The authors retrospectively analyzed the presentation,surgery and outcomes in 27 consecutive patients who underwent microresection of thalamic cavernous malformation.Results Forty - eight times of hemorrhage occurred to 27 patients with a preoperative Karnofsky Performance Scale （KPS） of 64.1 ± 9.7.Eighteen patients underwent transtrigone lateral ventricle approach,four patients experienced interhemispheric transcallosal approach,and other approaches were applied for the remaining five patients and complete resection was achieved in 96% of patients.After a mean follow - up duration of （48.7 ± 43.2） months,symptoms of weakness,paresthesia,difficulty in walking and vision improved by 53%,61%,25% and 67%.However,verbalization did not improved obviously.The recent KPS was 81.1 ± 15.8,22 patients improved and 5 stabilized.Preoperative status and gender were the positive predictors of outcome.Conclusions Patients with thalamic cavernous malformation could obtain favorite prognosis through microsurgery.

关 键 词：中枢神经系统血管畸形 显微外科手术 预后 丘脑 

分 类 号：R651.12[医药卫生—外科学]