[1]姚国杰　杨　铭　潘　力　杜　威　李成才　韦　可　肖炳祥　向伟楚　马廉亭.毗邻脑干的大型实质性血管母细胞瘤的外科治疗（附2例报告）[J].中国临床神经外科杂志,2015,(08):449-452.[doi:10.13798/j.issn.1009-153X.2015.08.001]
　YAO Guo-jie,YANG Ming,PAN Li,et al.Microsurgery for giant solid hemangioblastomas nearby brainstem (report of 2 cases)[J].,2015,(08):449-452.[doi:10.13798/j.issn.1009-153X.2015.08.001]
点击复制

毗邻脑干的大型实质性血管母细胞瘤的外科治疗（附2例报告）()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2015年08期
页码:
449-452
栏目:
论著
出版日期:
2015-08-25

文章信息/Info

Title:
Microsurgery for giant solid hemangioblastomas nearby brainstem (report of 2 cases)
文章编号:
1009-153X（2015）08-0449-04
作者:
姚国杰　杨　铭　潘　力　杜　威　李成才　韦　可　肖炳祥　向伟楚　马廉亭
430070 武汉，广州军区武汉总医院神经外科（姚国杰、杨铭、潘　力、杜　威、李成才、韦　可、肖炳祥、向伟楚、马廉亭）
Author(s):
YAO Guo-jie;  YANG Ming;  PAN Li;  DU Wei;  LI Cheng-cai;  WEI Ke;  XIAO Bing-xiang;  XIANG Wei-chu;  MA Lian-ting.
Department of Neurosurgery, Wuhan General Hospital, Guangzhou Command, PLA, Wuhan 430070, China
关键词:
血管母细胞瘤; 脑干; 显微手术; 三维影像融合; 神经导航
Keywords:
Giant solid hemangioblastomas;  Brainstem;  Three-dimensional image fusion;  Neuronavigation;  Microsurgery
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2015.08.001
文献标志码:
A
摘要:
目的 探讨毗邻脑干的大型实质性血管母细胞瘤的外科治疗方法。方法 回顾性分析2例经术后病理证实的毗邻脑干的实质性血管网织细胞瘤患者的临床资料，瘤体最大径分别为5.1 cm和6.5 cm。结果 1例患者通过1次术前栓塞后，在术中历经23 h全切肿瘤；另1例患者通过2次术前栓塞，术前MRI与 DSA三维影像融合，术中神经导航，历经5 h全切肿瘤。术后2例患者均未发生神经功能障碍。结论 对于巨大型实质性血管母细胞瘤，术前有效的供血动脉栓塞是有必要的，术前MRI与3D-DSA三维影像动态融合可以减少手术创伤，术中利用娴熟的显微外科技术分流脑干和肿瘤的界面力争全切。
Abstract:
Objective To explore the strategy of the microsurgical treatment of giant solid hemangioblastomas (HB) nearby brainstem. Methods The clinical data of 2 patients with giant solid HB nearby brainstem (their maximum diameters were 5.1 and 6.1 cm respectively) undergoing microsurgery between 2011 and 2015 were analyzed retrospectively. Results One preoperative embolization of the arteries feeding blood to the tumor was performed and then the tumor was totally resected by microsurgery lasting 23 hours in 1 patient. Two preoperative embolizations of the arteries feeding blood to the tumor were performed and then the tumor was totally resected by microsurgery lasting 5 hours in the other patient. No patients had new neurological deficits or worsening of preoperative symptoms after the operation. Conclusions The preoperative embolization of the arteries feeding blood to the tumors should be performed in order to reduce intraoperative bleeding in the patients with giant solid HB nearby brainstem. MRI and 3D-DSA images fusion before the operations is very helpful to decrease in operative damage to the cerebral tissues in the patients with giant solid HB nearby brainstem. The curative effect of microsurgery on the giant solid HB nearby brainstem is good, but the skilful microsurgical technique is necessary to totally resect the tumors.

参考文献/References:

[1] Rachinger J, BusleiR, Prell J, et al. Solid haemangioblast-omas of the CNS: a review of 17 consecutive cases [J].Neurosurg Rev, 2009, 32(1): 37-47.
[2] Chen LF, Yang Y, Yu XG, et al. Operative management of brainstem hemangioblastomas [J]. J Clin Neurosci, 2013, 20(12), 1727-1733.
[3] 盛柳青，李　俊，陈　刚，等. MRI与DSA三维影像数据输入神经导航融合行脑深部血管病直视手术的探讨[J]. 中国临床神经外科杂志，2015，20（4）：193-197.
[4] 马廉亭，杨　铭，李　俊，等. DSA影像融合处理新技术进展及其在神经外科的应用[J]. 中国临床神经外科杂志，2013，18（10）：626-629.
[5] Sheng LQ, Li J, Li HH, et al. Evaluation of cerebral arterio-venous malformation using ’dual vessel fusion’ technology[J]. J Neurointervent Surg, 2014, 6(9): 667-671.
[6] 向伟楚，李欢欢，李国栋，等. “双血管三维影像融合” 对脑血管病诊治评估的价值[J]. 中国临床神经外科杂志，2015，20（1）：1-4.
[7] 延鹏翔，王忠诚，于春江，等. 小脑实性血管网织细胞瘤的诊断和显微外科治疗[J]. 中华外科杂志，2004，42（13）：777-780.
[8] 郭付有，宋来君，孙红卫，等. 显微手术治疗颅内实质性血管网织细胞瘤[J]. 山东医药，2010，50（2）：54-55.
[9] 谢朝晖，马　强，刘铁峰，等. 小脑实质性血管网织细胞瘤的MR诊断[J]. 临床和实验医学杂志，2008，7（6）：11-12.
[10] Zhou LF, Du GH, Mao Y, et al. Diagnosis and surgical treatment of brainstem hemangioblastomas [J]. Surg Neurol,2005, 63: 307-315.
[11] Pavesi G, Berlucchi S, Munari M, et al. Clinical and surgi-cal features of lower brain stem hemangioblastomas in von Hippel-Lindau disease [J]. Acta Neurochir (Wien), 2010, 152(2): 287-292.

相似文献/References:

[1]吕忠中　徐　韬　杨天明.超选择性栓塞联合显微手术治疗后颅窝实质性血管母细胞瘤[J].中国临床神经外科杂志,2015,(05):274.[doi:10.13798/j.issn.1009-153X.2015.05.006]
　Lü Zhong-zhong,XU Tao,YANG Tian-ming..Applicattion of preoperative superselective endovascular embolization to microsurgery for substantial posterior fossa hemangioblastomas[J].,2015,(08):274.[doi:10.13798/j.issn.1009-153X.2015.05.006]
[2]吴国鑫　廖圣芳　黄国河　陈汉民.神经导航辅助下显微手术切除血管母细胞瘤[J].中国临床神经外科杂志,2016,(10):611.[doi:10.13798/j.issn.1009-153X.2016.10.014]
[3]黄常坚,黄　玮.85例中枢神经系统血管母细胞瘤的手术治疗[J].中国临床神经外科杂志,2016,(11):694.[doi:10.13798/j.issn.1009-153X.2016.11.013]
[4]徐春华　李东海　刘　越.右小脑血管母细胞瘤合并右侧侧脑室中枢神经细胞瘤1例[J].中国临床神经外科杂志,2017,(06):448.[doi:10.13798/j.issn.1009-153X.2017.06.031]
[5]王登元 综述 王亚明 白茫茫 审校.立体定向活检术在儿童脑干胶质瘤中的应用[J].中国临床神经外科杂志,2018,(11):763.[doi:10.13798/j.issn.1009-153X.2017.11.022]
[6]符俊骐　夏　鹰　金　虎等.多手段联合辅助显微手术治疗颅后窝血管母细胞瘤[J].中国临床神经外科杂志,2021,26(02):115.[doi:10.13798/j.issn.1009-153X.2021.02.016]

更新日期/Last Update: 2016-08-25