Kawase’s入路切除脑干海绵状血管瘤的临床研究

Clinical Study of Kawase's Approach for Resection of Brainstem Cavernous Hemangioma

目的:探讨Kawase’s入路切除脑干海绵状血管瘤的临床疗效。方法:肿瘤位于中脑下部腹外侧、桥脑腹外侧和侧方海绵状血管瘤患者30例,采用Kawase’s入路切除手术,观察患者术后全切除率,分别于入院、出院时采用汉化版简明健康调查表(SF-36)评估患者生活质量,于术前、术后12月分别采用改良Rankin量表(m RS)和日常生活活动能力(ADL)量表评价患者的神经功能。结果:术后全切除率为96.7%。出院时患者的SF-36量表评分优于入院(P<0.05或P<0.01);术后12月,术后m RS评分、ADL评分均优于术前(P<0.05或P<0.01);Cox模型分析结果显示,Kawase’s入路、术前为再次出血、病变部位、肿瘤大小以及术中肿瘤切除程度为BCM预后的危险因素。结论:Kawase’s入路切除肿瘤位于中脑下部腹外侧、桥脑腹外侧和侧方海绵状血管瘤临床效果显著。

Objective： To investigate the clinical effects of Kawase approach for resection of brainstem cavernous hemangioma（BCM）. Methods： The Kawase approach was performed on 30 patients with cavernous hemangioma located in the lower part of the midbrain ventrolateral, pons ventrolateral and side. The total resection rate,quality of life of patients by SF- 36 before and after admission were evaluated; neurological function was assessed by Modified Rankin Scale（m RS） and activities of daily living（ADL） before operation and 12 months after operation. Results： The postoperative total resection rate was 96.7%.The SF-36 scale scores were higher at discharge. The ADL and m RS scores of postoperative and postoperative at month 12 were both better than that preoperative. Cox model analysis showed that the Kawase approach, preoperative hemorrhage, the location and size of the tumor, and the extent of tumor resection were all risk factors for the prognosis of BCM. Conclusion：Kawase＇s approach for resection of brainstem cavernous hemangioma showed significant clinical effect.