延髓背侧血管母细胞瘤的显微外科治疗(10例报告)

Microsurgical technique in hemangioblastoma in dorsal surface of the medulla oblongata:A report on 10 cases.

目的探讨延髓背侧血管母细胞瘤的影像学特征、显微外科手术技巧以及并发症的防治。方法回顺性分析10例经手术和病理证实的延髓背侧血管母细胞瘤的临床资料和手术疗效。结果8例肿瘤全部切除,随访3～45个月,正常工作学习7例、生活自理1例,2例次全切除者于术后25 d、半年因呼吸衰竭及顽固性消化道出血死亡。结论头部MR、DSA对本病的诊断具有重要的价值,正确的手术处理原则及娴熟的显微外科手术技巧可提高本病的疗效,术前早期给予制酸剂、术后早期置胃管、气管切开对及时发现和治疗并发症具有重要意义。

Objective To discuss the imaging characteristics, microsurgical technique, and methods for prevention of complications in the treatment of hemangioblastoma in dorsal surface of the medulla oblongata. Methods We performed a retrospective analysis of the clinical presentation, surgical treatment, and outcomes in 10 cases of hemangioblastoma which were confirmed by surgical operation and pathology. Results In 8 cases the tumors were totally removed with 3 - 45 months long term follow up. Seven patients went back to normal life. One patient is alive at a level of basic independence. Two patients died, one at 25 days and the other one half year after operation because of respiratory failure and persistent alimentary tract hemorrhage. Conclusions Magnetic Resonance Imaging and DSA have important value in the diagnosis of such disease. Proper surgical management and adept operative technique can improve the curative effect of hemangioblastoma. Antacid drugs used before operation, gastric drainage, and tracheostomy after operation help to discover and treat complications.