脑干血管母细胞瘤的显微外科治疗(附15例报告)

Microsurgical Treatment of Brainstem Hemangioblastoma:A Report of 15 Cases

目的:探讨脑干血管母细胞瘤的诊断及显微外科手术方式、技巧与效果。方法:回顾性分析15例脑干血管母细胞瘤患者的影像学资料、手术方式、治疗效果。结果:根据肿瘤在MRI上的表现可分为囊肿型和实体型:囊肿型4例,实体型11例。15例患者病灶均于显微镜下全切,无手术死亡,术后病理学检查证实为血管母细胞瘤。8例患者术后神经功能障碍得到改善,4例症状加重,3例术后1周左右死亡,死亡原因均为脑干功能障碍。结论:MRI对脑干血管母细胞瘤的定位、定性诊断具有重要意义,对手术方式的选择具有重要参考价值。采用显微外科技术切除脑干血管母细胞瘤是提高治疗效果的有效方法。

Objective：To investigate the diagnosis and technique,and the effectiveness of microsurgical treatment of brainstem hemangioblastoma.Methods：A retrospective review was done on 15 patients with brainstem hemangioblastoma.Results：On magnetic resonance imaging （MRI）,the tumors could be divided into two types：Cystic type 4 cases,and solid type 11 cases.All of the 15 lesions were removed under microscope without death toll.Histopathological examination revealed hemangioblastoma.Postoperatively,the functional disorders of the nervous system were improved in 8 cases,but 4 cases were deteriorated after operation,3 cases died in about one week after operation because of brainstem functional disturbance.Conclusion：The MRI of brainstem hemangioblastoma was particularly important in the determination of localization and qualitation of the tumors with resultant choice of selecting appropriate operative method.It was an effective treatment by using the microsurgical technique to removal brainstem hemangioblastoma.