中国现代神经疾病杂志 ›› 2014, Vol. 14 ›› Issue (7): 628-632. doi: 10.3969/j.issn.1672-6731.2014.07.015

• 临床研究 • 上一篇    下一篇

2 脊髓髓内血管母细胞瘤栓塞治疗价值和手术体会

杨威, 左锋   

  1. 100029 首都医科大学附属北京安贞医院神经外科
  • 出版日期:2014-07-25 发布日期:2014-07-27
  • 通讯作者: 杨威 (Email:yw0926@sohu.com)

Evaluation of preoperative embolization and surgical experience for spinal cord hemangioblastoma

YANG Wei, ZUO Feng   

  1. Department of Neurosurgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
  • Online:2014-07-25 Published:2014-07-27
  • Contact: YANG Wei (Email: yw0926@sohu.com)

摘要: 目的 探讨脊髓髓内血管母细胞瘤术前栓塞治疗方法及其在外科手术中的价值。方法 根据脊髓MRI和DSA 检查所见,选择具备术前栓塞适应证病例,并制定手术方案。结果 共13 例患者,选择10 例肿瘤供血动脉顺畅、微导管易于通过病变血管的患者行术前栓塞治疗。13 例患者均经手术全切除肿瘤,术后症状与体征好转12 例、无变化1 例。结论 脊髓血管造影术能够明确脊髓髓内血管母细胞瘤供血情况,通过术前栓塞治疗可以减少肿瘤血供、降低肿瘤表面张力;术中沿肿瘤界面分离,先离断动脉再处理静脉以减少出血,从而达到肿瘤全切除。

关键词: 血管母细胞瘤, 脊髓肿瘤, 栓塞, 治疗性, 血管造影术, 数字减影

Abstract: Objective  The aim of this study was to investigate whether preoperative embolization would facilitate spinal cord hemangioblastoma (SCH) resection, and the surgical experience was also summarized.  Methods  Clinical data and radiological studies of 13 patients with SCH admitted in our hospital from January 2000 to December 2010 were retrospectively reviewed. Spinal MRI and DSA studies as well as histological diagnoses were available in all patients.  Results  Preoperative MRI and DSA were performed in all cases and preoperative superselective embolization in 10 cases. Total resection was achieved in all cases. During the follow-up period, 12 patients were improved, while one case remained stable.  Conclusions  Spinal DSA could be indicated to demonstrate the vascularity of SCH. Preoperative superselective embolization would be effective in reducing blood supply and tension of tumor, thus facilitating total resection with minimal bleeding. When separating the tumor, artery should be clipped firstly, followed by dealing with vein, which also contributed to reduction of bleeding.

Key words: Hemangioblastoma, Spinal cord neoplasms, Embolization, therapeutic, Angiography, digital subtraction