中枢神经系统血管母细胞瘤的诊断与治疗

目的：分析中枢神经系统血管母细胞瘤(Hemangioblastomas)的临床特点。方法：回顾性分析我科1989—2002年收治的198例中枢神经系统血管母细胞瘤，均经手术及病理证实。结果：肿瘤常见发病年龄为20-45岁，多见于后颅窝，囊性152例，实质性46例，绝大部分行CT检查，57例行MRI检查，5例行DSLA检查。囊性瘤全切147例，死亡3例；实质性肿瘤全切38例，部分切除8例，死亡6例。结论：CT、MRI和DSA检查是明确诊断的必要手段；手术切除肿瘤仍是最重要的治疗措施；术前栓塞供血动脉、术中控制性降压和术后立体定向放射神经外科治疗是实质性血管母细胞瘤的有效辅助治疗方法。

Study of the Clinical Features Hemangioblastomas of the Central Nervous System

Objective:Study of the clinical features of hemangioblastomas of the central nervous system.Methods:One hundred and ninty-eight patients with hemangioblastomas of CNS from 1989 to 2002 were reviewed.All patients were verified by surgery and pathology.Result:The tumors occurred mainly in patients between 20 and 45 years of age.Most tumors were in the posterior fossa.152 patients the lesions were cystic,and other 46 patients were solid.Most patients were examined with CT,in which 57 with MRI,and 5 with DSA.Surgical removal was accomplished in all patients.The mural nodules were completely removed in 147 cystic cases,and 3 patients died.Total tumor removal was accomplished in 38 solid cases,partial removal in 8 cases,and 6 patients died.Conclusion:CT?MRI or DSA is necessary for diagnosis.Surgical removal is the most important therapeutic method.Preoperative endovascular embolisation?controlled depression of tension during operation and postoperative sterotherapy play a good role in whole ragime.