[1]辛　灿,许双祥,王　煜,等.显微手术治疗脑干海绵状血管瘤的临床分析[J].中国临床神经外科杂志,2016,(12):737-739.[doi:10.13798/j.issn.1009-153X.2016.12.001]
　XIN Can,XU Shuang-xiang,WANG Yu,et al.Clinical analysis of microsurgery for brainstem cavernous malformations[J].,2016,(12):737-739.[doi:10.13798/j.issn.1009-153X.2016.12.001]
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显微手术治疗脑干海绵状血管瘤的临床分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2016年12期
页码:
737-739
栏目:
论著
出版日期:
2016-12-25

文章信息/Info

Title:
Clinical analysis of microsurgery for brainstem cavernous malformations
文章编号:
1009-153X（2016）12-0737-03
作者:
辛　灿; 许双祥; 王　煜; 游超; 何　跃; 陈劲草
（辛　灿,许双祥,王　煜,游超,何　跃）；430071 武汉，武汉大学中南医院神经外科（陈劲草）通讯作者：陈劲草，E-mail：chenjincao@hotmail.com
Author(s):
XIN Can1;  XU Shuang-xiang1;  WANG Yu1;  YOU Chao1;  HE Yue1;  CHEN Jin-cao2
1. Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; 2. Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan 430071, China
关键词:
脑干海绵状血管瘤; 显微手术; 疗效
Keywords:
Brainstem cavernous malformation;  Microsurgery;  CT;  MRI;  Sitting position
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2016.12.001
文献标志码:
A
摘要:
目的 探讨脑干海绵状血管瘤的显微手术治疗方法及其疗效。方法 回顾性分析2011年10月至2015年9月显微手术治疗的19例脑干海绵状血管瘤的临床资料，其中桥脑12例，中脑4例，延髓2例，桥脑延髓交界区1例。经坐位枕下后正中小脑延髓裂入路12例，坐位乙状窦后入路4例，坐位后正中幕下小脑上入路2例，翼点入路1例。结果 病灶全切除17例，次全切除2例。术后症状改善16例，无明显变化3例，无手术死亡病例。术后随访14~58个月，次全切除2例均复发并行二次手术；术前KPS评分为（75±6）分，术后KPS评分为（84±8）分，随访1年KPS评分为（90±5）分。结论 应根据术前影像学检查以及术者经验及习惯选择手术方式，坐位可以作为大部分脑干海绵状血管瘤的常规手术体位；显微手术治疗脑干海绵状血管瘤应在保证安全的前提下做到全切除，使患者获得良好预后。
Abstract:
Objective To investigate the surgical method for brainstem cavernous malformations (BSCMs) and its curative effects. Methods The clinical data of 19 patients with BSCMs undergoing microsurgery from October, 2009 to September, 2015 were analyzed retrospectively. Of 19 BSCMs, 12 were in the pontes, 4 in the mesencephalons, 2 in the medullas oblongatae and 1 in the pontomedullary junction. Of 19 patients, 12 underwent microsurgery via suboccipital cerebellomedullary fissure, 4 via retrosigmoid approach, 2 via infratentorial-supracerebellar approach and 1 via pterional approach. CT and MRI examinations were performed before and after the operation in all the patients, in whom the pathological examination was performed after the operation. Results Total resection of BSCMs was achieved in 17 and subtotal in 2. The clinical symptoms were improved in 16 patients and unchanged in 3. Two patients, who received subtotal resection, recurred and received the second operation within 3 years after the first operation. No one died of the operation in all the patients. Conclusions The surgical approach should be chosen according to the imaging examination and the experiences of surgeons. Sitting position can be applied during the surgery in most of patients with BSCMs. Microsurgery is an effective method to treat BSCMs and good prognoses may be obtained by total resection of the tumors in the patients with BSCMs.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目：国家自然科学基金（81400975）作者单位：430030 武汉，华中科技大学同济医学院附属同济医院神经外科
更新日期/Last Update: 1900-01-01