经四脑室底切除桥脑海绵状血管瘤临床疗效分析

Curative efficacy of pontine cavernous hemangioma by trans-forth ventricle approach

目的分析桥脑海绵状血管瘤的病史、手术疗效及预后,探讨最佳手术入路,减少并发症。方法回顾性分析徐州医科大学附属医院神经外科2014年1月至2018年8月收治的9例桥脑海绵状血管瘤患者的病例特点及手术效果。结果9例患者病灶根据病变部位选择正确的手术入路全切除,术后4例神经功能改善,术后5例患者新增一过性神经功能障碍,其中眼震、视物模糊等眼球运动障碍2例,吞咽困难1例,面瘫2例。术后1个月mRS评分与术前比较,差异无统计学意义(P>0.05)。术后6个月mRS评分与术前比较,差异有统计学意义(P<0.05)。结论枕下后正中经四脑室底入路可以有效地切除桥脑海绵状血管瘤,患者术后症状改善明显,预后良好,生活质量提高。

Objective To explore the best surgical approach for pontine cavernous hemangioma by investigating the natural history,surgical efficacy and prognosis,and to reduce the complication rate.Methods The characteristics and surgical results of 9 patients with pontine cavernous hemangioma in neurosurgery department of affiliated hospital of Xuzhou medical university from January 2014 to August 2018 were retrospectively analyzed.Results Lesions were completely removed in 9 patients,and neurological function was improved in 4 cases after operation,5 patients had temporary neurological dysfunction,including 2 cases of eye movement disorders such as nystagmus and blurred vision,1 case of dysphagia and 2 cases of facial paralysis.Statistical analysis showed that there was no statistical significance in mRS score one month after surgery compared with that before surgery(P>0.05).The mRS score at 6 months after operation was statistically significant compared with that before operation(P<0.05).Conclusion Trans-forth ventricle approach can effectively remove the potine cavernous hemangioma,significantly improved the postoperative symptoms,with good prognosis and high quality of life.