脑干海绵状血管瘤的显微手术治疗

目的:探讨显微外科手术不同入路治疗脑干海绵状血管瘤的临床途径和疗效。方法:选取我院10例脑干海绵状血管瘤患者,并根据其病灶的不同部位分别采用不同手术入路行显微外科手术治疗,观察其临床疗效。结果:本组10例脑干海绵状血管瘤全切7例,次全切除2例,大部切除1例;术后随访6～24个月均获良好预后,脑干血管瘤原发临床症状如头痛、呕吐、肿瘤压迫症状、共济失调、偏瘫、吞咽困难等基本消失,除1例延髓海绵状血管瘤患者术后出现呼吸困难新症状,余大部分患者均能够进行正常的学习和工作,未见手术后致残、生活不能自理等后遗症的发生;手术前后的生活质量评分具有显著性差异(P<0.05)。结论:显微外科手术治疗脑干海绵状血管瘤应根据患者病灶的不同部位选择不同手术入路,能显著提高显微外科手术的临床疗效,改善患者预后,提高患者术后生活质量。

On the microsurgery of brainstem cavernomas

Objective: To investigate the clinical pathways and analyze the different curative effects of the microsurgical operations in the treatment of brainstem cavernous hemangioma.Methods: 10 cases of brain tumor patients in our hospital were selected and treated respectively with different operation approaches of microsurgical treatment according to the different parts of the brain tumor lesions,then the curative effect were observed.Results:Of the 10 cases of brainstem cavernous hemangioma,7 cases were performed angioma resection,2 subtotal resection and 1 subtotal removal.Patients,followed up for 6~24 months after operations,had been found in good prognoses.All the primary clinical symptoms of the brainstem angioma,such as headache,vomiting,papilloedema,tumor compression,endocrine,ataxia,paralysis and dysphagia had almost disappeared except for 1 patient with cavernous hemangioma in medulla oblongata showed new postoperative dyspnea symptom.Most of the patients were able to perform the normal work and study,there occurred no disability and the sequelae of lacking the abilities to take care of themselves after operations.The preoperative and postoperative quality of life scores had significant difference(P<0.05).Conclusion: In microsurgical treatment of brainstem cavernous angioma,different approaches should be chosen based on the lesions in different parts of the patients can significantly improve the clinical effect of microsurgeries,the prognosis and the quality of life in patients as well.