后颅窝血管网织细胞瘤  

Hemangioblastomas of the posterior cranial

作　　者：李相龙[1] 孙京和[1] 王延国[1] 赵春植[1] 韩东汉[1] 金永寿[1] 金光石[1] 任光旭[1] 玄汉石[1] 

机构地区：[1]延边大学医学院附属医院神经外科,吉林延吉133000

出　　处：《中风与神经疾病杂志》2002年第4期238-239,共2页Journal of Apoplexy and Nervous Diseases

摘　　要：目的 分析后颅窝血管网织细胞瘤的特点,设计治疗方案,估计和预防术后并发症,降低致残率和死亡率。方法 回顾性分析1998年10月至2001年9月手术治疗和病理证实的7例后颅窝血管网织细胞瘤的临床资料。结果　7例血管网织细胞瘤分布在后颅窝的右侧小脑（2例）、左侧小脑（1例）、小脑蚓部（2例）及延髓背侧（2例）。2例为实质性肿瘤,5例为囊内结节样肿瘤,全部切除。3例出现不同程度的呼吸障碍和上消化道应激性溃疡出血,其中1例死亡。结论 血管网织细胞瘤在MRI上有其特点,能够术前作出诊断。对实质性肿瘤切忌术中穿刺或活检.更不能分块切除。这种肿瘤术后很有可能出现正常灌注压突破现象,必要时毫不犹豫地进行气管切开,辅以人工呼吸。小的实质性肿瘤或囊内结节样肿瘤手术是相对安全的。Objective To analyse the clinical features of hemangioblastomas of the posterior cranial,design the surgical treatment,estimate and reduce the postoperative complications and mortality. Methods Seven cases of hemangioblatomas un-derwent operation from Octorber 1998 to September 2001 were analyzed retrospectively. Results Two tumors were located on the right side of cerebellum, 1 on the left side of cerebellum,2 on the vermis cerebellum,and 2 on the back of medulla ob-longata. 2 cases were solid tumor and 5 introcystic nodular tumor. All of the 7 cases were excised totally and comfirmed by pathological report. Three cases suffered different degrees of dypnea and stress related gastric ulcer and 1 died. Conclusion The hemangioblastomas can be correctly diagnosed before operation because of its characteristics in MRI. Biopsy and partial removal should be nevere performed for solid tumors. This kind of tumor can cause normal perfusion pressure breakthrough (NPPB) after operation, so it is necessary to make tracheotomy and assistant artificial respiration. The operation can be per-formed safely on the small solid tumor and introcystic nodular tumor.

关 键 词：后颅窝血管网织细胞瘤 手术 正常灌注压突破现象 

分 类 号：R739.41[医药卫生—肿瘤]