脊髓血管母细胞瘤的显微外科治疗

Exploration on the Microsurgical Treatment of Spinal Hemangioblastomas

目的:提高脊髓血管母细胞瘤的疗效。方法:回顾性分析98例脊髓血管母细胞瘤患者的临床表现、影像学特点、治疗方法及预后。结果:98例患者共全切除肿瘤105个;死亡2例。随访70例患者,疼痛、肌力下降和二便障碍症状好转率分别为83.6%、56.8%和50.0%;不变率分别为10.9%、29.7%和43.8%;加重率为5.5%、13.5%和6.2%。结论:MRI是脊髓血管母细胞瘤最主要的诊断方法;DSA是有效的辅助诊断及治疗手段;手术切除是目前治疗脊髓血管母细胞瘤的首选方法,娴熟的显微外科技术是手术成功最重要的保证。

To improve the efficacy of treatment about spinal hemangioblastoma. Methods： Clinical manifestations, imaging data, managements and prognosis of 98 cases with spinal hemangioblastomas were retrospectively analyzed. Results： 105 procedures of total resection about 98 cases were performed, and 2 patients died during peri-operative periods. Among 70 follow-up cases, the rates of improvement of pain, strength decrease, sphincter dysfunction were 83.6%, 56.8%, 50.0% respectively;the rates of invariant were 10.9%, 29.7%, 43.8%, respectively; the rates of aggravation were 5.5%, 13.5%, 6.2%, respectively. Conclusion： MRI（magnetic resonance imaging） is recommended as the principal diagnostic method for spinal hemangioblastomas, and DSA（digital subtraction angiography） can be an auxiliary tool for its diagnosis and management. Surgery is its prior protocol of treatment, and skillful microsurgical techniques are the base of the successful operation.