脊髓血管母细胞瘤的显微外科治疗及远期随访  

Spinal hemangioblastomas： microsurgical treatment and long-term follow-up

作　　者：齐巍[1] 杨涛[1] 吴量[1] 徐宇伦[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：《肿瘤研究与临床》2016年第3期183-186,191,共5页Cancer Research and Clinic

基　　金：Beijing Municipal Natural Science Foundation，北京市自然科学基金

摘　　要：目的 总结脊髓血管母细胞瘤的显微外科手术治疗经验并评价其远期疗效.方法 回顾性分析46例脊髓血管母细胞瘤患者的临床及影像学资料.所有患者均在显微镜下行肿瘤切除,术前均未行栓塞治疗,共行52次手术,切除肿瘤58枚.采用McCormick分级进行脊髓功能评估,术后平均随访8年.结果 肿瘤全切除55枚,次全切除3枚.术后1周症状改善11例,无变化29例,加重6例.无手术死亡病例.随访7～9年,脊髓功能改善18例,无明显变化21例,加重7例;未见肿瘤复发.肿瘤次全切除影响预后（P=0.08, OR=10.8,95％置信区间2.1～60.8）.结论 脊髓血管母细胞瘤为高度血管化的良性肿瘤,可通过显微镜下全切除治愈.肿瘤次全切除是影响预后的危险因素.Objective To summarize the treatment experiences and long-term surgical efficacy of spinal hemangioblastomas.Methods The surgical experiences of 46 patients with spinal hemangioblastomas were analyzed retrospectively.All patients underwent microsurgical resection without preoperative embolization, and 52 operations were performed and 58 tumors were resected.McCormick classification was used to evaluate the function of spinal cord.The mean follow-up time was 8 years.Results Total tumor resection was achieved in 55 tumors and subtotal ones in 3.A week later, improvement was obtained in 11 cases, no changes in 29 and aggravation in 6.No patients died.During a follow-up period from 7 to 9 years, the spinal function was improved in 18 patients, remained stable in 21 and deteriorated in 7.No tumor recurrence was found.The subtotal resection affected the prognosis （P =0.08, OR =10.8, 95 % CI 2.1-60.8）.Conclusions The spinal hemangioblastomas are highly vascularized benign tumors that can be surgically cured under microscope.Subtotal resection is a risk factor of prognosis.

关 键 词：脊髓肿瘤 血管母细胞瘤 显微外科手术 

分 类 号：R739.4[医药卫生—肿瘤]