延脊髓型脑干肿瘤的诊断和显微手术切除

The diagnosis and microsurgery of medullary-spinal brain stem tumors

目的探讨延脊髓型脑干肿瘤的诊断和显微手术治疗效果。方法16例患者经MRI诊断为延脊髓型脑干肿瘤。采用小脑延髓裂入路,于显微镜下手术切除病变及康复治疗。结果12例肿瘤达全切除,3例获次全切除,1例为部分切除。瘤标本经病理学检查分别为星形细胞瘤、胶质母细胞瘤、血管网状细胞瘤。临床痊愈出院11例,好转出院4例,死亡1例。结论MRI是诊断延脊髓型脑干肿瘤的最佳检查方法,采用显微手术治疗此类肿瘤,尽可能多的切除肿瘤,减少并发症,达到解除症状及延长生命的目的,手术效果良好。同时长期有效的后期康复治疗也很重要。

Objective To explore the diagnosis and outcome of surgery in medullary-spinal brain stem tumors.Methods 16 patients with medullary-spinal brain stem tumors were performed operation with cerebellar-medullary approach. Tumors were dissected under microscope, which was followed by rehabilitation care.Results Complete resection was performed in 12 cases, semi-complete resection in 3 cases and incomplete resection in 1 case. Pathological diagnoses were astrocytoma, gliobalstoma and angioreticuloma. Complete recovery was found in 11 cases and 4 case improved and 1 case died. Conclusion MRI is the best method in diagnosing medullary-spinal brain stem tumors. Resection under microscope may remove the tumor at the maximum extent and prevent the complications for clinical improvement and long survival. Long and effective rehabilitation care is also important.