延髓血管网状细胞瘤的显微手术治疗

Microsurgical treatment of angioreticuloma in the medulla oblongata

目的总结延髓血管网状细胞瘤的手术经验。方法回顾性分析48例延髓血管网状细胞瘤的临床资料。肿瘤为囊实型16例,实质型32例。肿瘤单发38例,多发10例。术中采用超声辅助寻找小的瘤结节,在脑干与肿瘤之间的胶质增生带整体切除瘤结节及囊变。结果肿瘤全切除45例,有小的结节遗留3例。随访41例,时间3～74个月,术后症状消失19例,好转18例,加重或出现新的症状4例;复发4例,死亡5例。结论延髓血管网状细胞瘤的显微手术效果良好,关键是在不损伤脑干的前提下,整体切除肿瘤及术后呼吸道的管理。

Objective To review the surgical experiences for angioreticuloma in the medulla oblongata.Methods Clinical data of 48 patients with angioreticuloma in the medulla oblongata were analyzed retrospectively,including 16 cystic-and solid-typed tumors,32 solid-type tumors,38 solitary nodules and 10 multiple nodules.Ultrasound Doppler was applied to locate the nodules,which should be totally removed with cystic changes within the gliosis zone between tumors and brain stem.Results Tumors were totally resected in 45 cases and small tumor nodules remained in 3.A follow-up of 3 to 74 months was performed in 41 cases：symptom disappearance after operation in 19 cases,improvement in 18,aggravation or new signs in 4;recurrence in 4 and death in 5.Conclusions The therapeutic effect of angioreticuloma is good and total resection of the tumor without damaging the brain stem and postoperative respiratory management are the key points.