颈髓髓内实体性血管网织细胞瘤的显微外科治疗

Microsurgical Resection of Solid Intramedullary Hemangioblastomas of Cervical Spinal Cord

目的为了提高颈髓髓内实体性血管网织细胞瘤的显微外科治疗水平。方法回顾性分析14例颈髓髓内实体性血管网织细胞瘤患者的临床表现及其显微外科手术治疗效果。结果所有患者均行了肿瘤全切除术,经病理检查证实为血管网织细胞瘤。术后患者神经系统症状好转者7例,5例无改善,2例加重。结论显微镜下沿正确的界面进行分离,先离断动脉后处理静脉,避免分块切除而力争全切,是减轻术中出血和避免神经功能损害的关键。虽然手术风险高,但对有明显临床表现的患者,宜应行积极的显微外科手术治疗,以终止症状发展和达到肿瘤痊愈。

Objective： To improve the surgical treatment of solid intrameduUary hemangioblastoma of cervical spinal cord. Methods; A retrospective review of 14 patients with solid intramedullary hemangioblastomas of the cervical spinal cord was conducted including the clinical manifestations and outcomes. Results： All the tumors underwent total removal and were all hemangioblastomas confirmed by histopatholagic examinations. Postoperatively, neurological status were improved in 7 cases, remained in 5 cases and worse in 2 cases. Conclusion： It is the most important principal that dissection is performed along the correct interface and the tumor should be removed en bloc after it is devascularized. Although it is high risk to operate at cervical section, microsurgical total resection is the optimal method to stop the development of the clinical presentation.