| 摘要: |
| 目的 总结脊髓血管母细胞瘤的诊疗经验,探讨其临床预后。方法 回顾性分析33例经手术后病理证实的脊髓血管母细胞瘤患者的临床资料。其中男24例,女9例;病变位于颈延髓交界区1例,颈段9例,颈胸段2例,胸段16例,胸腰段1例,腰段4例。术后长期随访患者预后情况,分析患者预后影响因素。结果 肿瘤全切32例,近全切1例,无手术死亡病例。随访16个月至12年,术后神经功能维持术前水平或好转29例(87.9%),其中按照McCormick分级标准,好转15例(45.5%),维持术前水平14例(42.4%);按照Klekamp-Samii评分,好转24例(72.7%),维持术前水平5例(15.2%)。4例患者恶化(12.1%)。患者术前神经功能状态与预后密切相关(P=0.033)。结论 脊髓血管母细胞瘤为富含血管的良性肿瘤,有症状者应早期手术;显微手术是首选治疗方法;术后大部分患者预后良好。术前神经功能状态与患者神经功能预后相关。 |
| 关键词: 脊髓肿瘤；血管母细胞瘤 显微外科手术 预后 |
| DOI： |
| 投稿时间：2013-05-06修订日期：2013-09-23 |
| 基金项目:上海市科学技术委员会科研计划项目(11DZ192130D). |
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| Microsurgical treatment of spinal cord hemangioblastoma: an analysis of long term prognosis |
| XIE Tian-hao,LU Yi-cheng,QIAN Jun,JIANG Yi-kun,LIU Fei-li,HU Guo-han,DING Xue-hua,CHEN Ju-xiang,LUO Chun* |
(Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
*Corresponding author.) |
| Abstract: |
| Objective To discuss the diagnosis, treatment and long term prognosis of the spinal hemangioblastoma. Methods The clinical data of 33 spinal hemangioblastoma cases, verified by microsurgeries and pathological results, were retrospectively analyzed. Twenty-four of them were males and nine were females. The magnetic resonance imaging(MRI)showed that the 33 cases included 1 medulla-cervical hemangioblastoma, 9 cervical hemangioblastomas, 2 cervical-thoracic hemangioblastomas, 16 thoracic hemangioblastomas, 1 thoracic-lumbar hemangioblastoma, and 4 lumbar hemangioblastomas. Results Total removal of hemangioblastomas was achieved in 32 patients and subtotal removal in 1, with no operation associated death. Post-operative follow-up period ranged from 16 months to 12 years. According to the McCormick scale, the functional outcomes were verified as 15(45.5%) improved, 14(42.4%) unchanged, and 4(12.1%) deteriorated. According to the Klekamp-Samii score, the functional outcomes were verified as 24(72.7%) improved, 5(15.2%) unchanged, and 4(12.1%) deteriorated. Fisher’s exact test showed that the pre-operation neuronal function was significantly associated with the prognosis (P=0.033). Conclusion Spinal hemangioblastomas are highly vascularized benign tumors, and should be resected early when the symptoms or signs present. Microsurgery is the prior protocol of treatment, and the prognosis after microsurgery is generally fine. Post-operative functional status is determined by pre-operation functional status. Klekamp-Samii score system is more suitable for the functional evaluation of spinal hemangioblastoma. |
| Key words: spinal cord neoplasms hemangioblastoma microsurgery prognosis |
