脊髓血管母细胞瘤的显微手术治疗

目的脊髓血管母细胞瘤相对少见，本文总结显微外科手术治疗脊髓血管母细胞瘤的经验，探讨其治疗方法。方法回顾性分析近10年来显微外科手术治疗12例脊髓血管母细胞瘤的临床资料、治疗方式及术后转归。结果本组12例患者中男7例，女5例；年龄25～54岁，平均37岁；8例为单发病灶：位于颈段2例，胸段5例，腰段1例；4例为多发病灶：1例为颈段2个病灶，1例为胸段2个病灶，2例为胸腰段各1个病灶。12例患者均经手术全切除病变，病理学诊断为血管母细胞瘤；术后运动及感觉障碍改善7例，不明显3例，即刻加重1个月内恢复2例；无手术死亡病例。随访6～60个月，未见1例复发。结论脊髓血管母细胞瘤手术治疗效果好，有症状者应早期手术治疗。强调显微手术镜下操作，有助于肿瘤全切除和保护脊髓。

Microsurgical management of the spihal hemangioblastomas

Objective Spinal hemangioblastomas are relatively rare.The study aims to identify features that might guide surgical management of the spinal hemangioblastomas.Methods The patients with spinal hemangioblastomas treated from 1997 to 2007 were reviewed.The preoperative characteristics,MRI studies,surgical management and outcome of these patients were analyzed.Results Twelve patients with spinal hemangioblastomas underwent microsurgical resection during the 10-year study period,including 7 men and 5 women ranging from 25 to 54 years with a mean age of 37 years.Eight of them had single lesions and the other 4 had multiple lesions.All of the tumors were radically resected and confirmed as hemangioblastoma by the pathological diagnosis.Postoperative functional assessment showed that the function of motion and sensation had improved in 7 patients and less improvement presented in 3 patients.Immediate postoperative neurological functions worsen in 2 cases with recovery in 1 month.No operation-related mortality.During 6 to 60 months' follow-up,no recurrence occurred.Conclusion Spinal hemangioblastomas can be safely removed in the majority of patients.Spinal hemangioblastomas can be removed when the symptoms or signs present.The microscope does a great help to a safe and easy operation.