髓母细胞瘤的显微手术治疗(附28例报告)

目的 探讨髓母细胞瘤显微手术治疗技巧及其临床疗效.方法 回顾性分析2001年7月至2011年7月显微手术治疗的28例髓母细胞瘤患者临床资料.所有患者术前均行CT和MRI检查.19例经小脑蚓部入路手术,9例经小脑延髓裂入路手术.结果 肿瘤全切除21例(75.0%),次全切除7例(25.0%);出院时GOS评分5分18例(64.3%),4分6例(21.4%),3分3例(10.7%),1分1例(3.6%).结论 髓母细胞瘤以显微手术治疗为主;选择合适的手术入路,术中精细操作避免重要神经结构和血管损伤,可减少术后并发症和提高其临床预后.

Microsurgery for medulloblastomas (report of 28 cases)

Objective To explore the techniques of microsurgery for medulloblastomas and to improve the clinical effect on them. Methods The clinical data of 28 patients with medulloblastomas, of whom, 19 underwent microsurgery through inferior vermis approach and 9 through cerebellomedullary fissure approach from July, 2001 to July, 2011, were analyzed retrospectively. All the patients received CT and MRI examinations before the microsurgery. Results Of 28 patients, 21 received total excision of the tumors and 7 subtotal. According to GOS, of 28 patients, 18 were recovered well (GOS, 5 points), 6 moderate disabled (GOS, 4 points), 3 severely disabled (GOS, 3 points) and 1 died on discharge from hospital. Conclusions Microsurgery is main method to treat medulloblastomas. The decrease in the postoperative complications and improvement of the short-term prognosis may be reached by the microsurgery through the proper approach and avoiding injuring the important nerve and vessels during the operation.