脊髓血管母细胞瘤的显微外科治疗

Microsurgical treatment of spinal cord hemangioblastoma

目的探讨脊髓血管母细胞瘤的显微外科治疗方法。方法回顾性分析16例脊髓血管母细胞瘤病人的临床资料。术前均行血管造影,其中完全栓塞或部分栓塞9例。术中采用吲哚菁绿血管造影再次确认相关血管,采用显微外科手术切除肿瘤。结果 16例脊髓血管母细胞瘤均全切除。术后随访3个月,根据McCormick脊髓功能状态分级:明显改善12例,无变化3例,加重1例。结论脊髓血管母细胞瘤通过显微外科手术切除可以取得良好疗效,术前血管造影栓塞和术中荧光血管造影有利于减少术中出血,提高手术安全性。

Objeetive To explore microsurgical techniques in the treatment of spinal cord hemangioblastoma. Methods The clinical data of 16 patients with spinal cord hemangioblastoma were analyzed retrospectively. The preoperative angiography was performed in all the patients, 9 of whom underwent complete or partial embolization. The intraoperative indocyanine green angiography was used to confirm the associated vessels again and the tumors were removed by microsurgery. Results Total tumor removal was achieved in all the patients. Spinal cord fimction was evaluated by McCormick grade： improvement was found in 12 patients, no change in 3 and worsening in 1 after 3 months of follow-up period. Conclusions Microsurgery of spinal cord hemangioblastoma can achieve good results. Preoperative angiographic embolization and intraoperative fluorescence angiography are helpful to reduce intraoperative bleeding and improve surgical safety.