[1]韩 硕 张晓华 金 珂 张封臣 徐天启 吕 涛 韩东华.脑干海绵状血管畸形的显微外科治疗[J].中国临床神经外科杂志,2018,(01):1-3.[doi:10.13798/j.issn.1009-153X.2018.01.001]
 HAN Shuo,ZHANG Xiao-hua,JIN Ke,et al.Strategy of microsurgery for brainstem cavernous malformations[J].,2018,(01):1-3.[doi:10.13798/j.issn.1009-153X.2018.01.001]
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脑干海绵状血管畸形的显微外科治疗()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2018年01期
页码:
1-3
栏目:
论著
出版日期:
2018-01-25

文章信息/Info

Title:
Strategy of microsurgery for brainstem cavernous malformations
文章编号:
1009-153X(2018)01-0001-03
作者:
韩 硕 张晓华 金 珂 张封臣 徐天启 吕 涛 韩东华
作者单位:200127 上海,上海交通大学医学院附属仁济医院神经外科(韩 硕、张晓华、金 珂、张封臣、徐天启、吕 涛);201399 上海,复旦大学附属浦东医院神经外科(韩东华)
Author(s):
HAN Shuo1 ZHANG Xiao-hua1 JIN Ke1 ZHANG Feng-chen1 XU Tian-qi1 Lü Tao1 Han Dong-hua2.
1. Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China; 2. Department of Neurosurgery, Pudong Hospital, School of Medicine, Fudan University, Shanghai 201399, China
关键词:
脑干海绵状血管畸形显微手术手术入路
Keywords:
Brianstem Cavernous malformations Microsurgery Surgical approach Outcomes
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2018.01.001
文献标志码:
A
摘要:
目的 探讨脑干海绵状血管畸形的手术入路、手术技巧及预后。方法 回顾性分析2004年1月至2017年1月手术治疗的24例脑干海绵状血管畸形的临床资料。结果 畸形全切除22例,部分切除2例。术后随访6个月~10年,2例发生肺炎,3例发生脑膜炎,经抗生素治疗后痊愈;5例发生永久性神经功能障碍,1例遗留轻微面瘫和吞咽困难,1例昏迷后自动出院。术后KPS评分[(75.83±21.04)分]明显高于术前[(64.58±10.62)分;P<0.05]。结论 对于脑干海绵状血管畸形,应严格掌握手术指征和时机,术中根据位置选择不同的手术入路,利用神经导航及电生理监测,采取两点定位法,对神经功能的保护至关重要。
Abstract:
Objective To evaluate the approach, skill and outcomes of surgery for brainstem cavernous malformations (BSCM). Methods The clinical data of 24 patients with BSCM, who was treated microsurgically in our hospital from January, 2004 to January, 2017, was analyzed retrospectively. All the patients were followed up for 0.5 to 10 years. Results The total resection of BSCM was achieved in 22 patients and partial resection in 2. The pneumonia occurred in 2 patients, meningitis occurred in 3, permanent neurological disfunction occurred in 5 after the surgery. The discharge from hospital against advice occurred in 1 patient with coma after the surgery. The postoperation Karnofsky performance scores were significantly improved compared with the preoperation (P<0.05). Conclusions The patients with BSCM accompanied with progressive nerve dysfunction, especially those near the surface of brainstem should be treated by microsurgery. The neuronavigation and the appropriate surgical approach according to two-point location method are very important to protecting the neurologic function intraoperatively in the patients with BSCM.

参考文献/References:

[1] Starke RM. Do brainstem cavernous malformations have a higher rate of hemorrhage [J]? Expert Rev Neurother, 2015, 15(10): 1109-1111.
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[4] Zaidi HA, Mooney MA, Levitt MR, et al. Impact of timing of intervention among 397 consecutively treated brainstem cavernous malformations [J]. Neurosurgery, 2017, 81(4): 620-626.
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[6] Linsler S, Oertel J. Endoscopic endonasal transclival resec- tion of a brainstem cavernoma: a detailed account of our technique and comparison with the literature [J]. World Neurosurg, 2015, 84(6): 2064-2071.
[7] Garcia RM, Ivan ME, Lawton MT. Brainstem cavernous malformations: surgical results in 104 patients and a pro- posed grading system to predict neurological outcomes [J]. Neurosurgery, 2015, 76(3): 265-277.
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备注/Memo:
通讯作者:张晓华,E-mail:zxh1969@aliyun.com
更新日期/Last Update: 2017-12-27