CAJ | 학술논문

目的探讨脑干海绵状血管瘤显微手术治疗的适应证及预后.方法对14例行显微手术治疗的脑干海绵状血管瘤患者的临床资料及手术效果进行分析总结.结果 9例全切,4例次全切,其中1例于术后第3天再出血而死亡,另1例大部分切除.术后早期神经功能障碍改善6例,同术前5例,加重3例.随访6～38个月,仍有2例患者未恢复至术前状态.肿瘤未全切的4患者中有2例行放射治疗,肿瘤体积未见明确增大.肿瘤全切的9例患者生存良好,未见确切复发,亦无再次出血.结论对有手术指征的脑干海绵状血管瘤,积极行显微手术治疗效果良好.
목적 탐토뇌간해면상혈관류현미수술치료적괄응증급예후.방법 대14례행현미수술치료적뇌간해면상혈관류환자적림상자료급수술효과진행분석총결.결과 9례전절,4례차전절,기중1례우술후제3천재출혈이사망,령1례대부분절제.술후조기신경공능장애개선6례,동술전5례,가중3례.수방6～38개월,잉유2례환자미회복지술전상태.종류미전절적4환자중유2례행방사치료,종류체적미견명학증대.종류전절적9례환자생존량호,미견학절복발,역무재차출혈.결론 대유수술지정적뇌간해면상혈관류,적겁행현미수술치료효과량호.
Objective To explore the outcome and indication of microsurgery in brainstem.Methods We retrospectively reviewed 14 patients diagnosed as brainstem cavernomas and treated by microsurgery from 2000 to 2007.All of the 12 patients underwent surgical resection of the tumor as the initial treatment.Their clinical manifestations and surgical outcomes were analyzed in order to evaluate the significance of microsurgery.Results Of the 14 brainstem cavernomas cases,total resection and sub-total resection was achieved in 9 and 4 cases,respectively.One case with the sub-total resection of the brain stem cavernomas suffered from re-bleeding of the tumor which happened three days after tumor resection and died the next day.Partial tumor resection was obtained in the left case.At the early stage,the post-operational nerve function was improved in 6 cases,kept the same level in 5 cases,and became worse in 3 cases.All patients were followed up for about 6 to 38 months,in which only 2 cases still did not recover to the preoperational state.The volume of the lension changed slightly in the 2 cases whose tumor was sub- totally dissected and took radiotherapy after operation.There was no recurrence and bleeding occurred to the 9 cases whose tumor was totally dissected and they survived well.Conclusion Satisfactory clinical outcome of microsurgery for brainstem cavernomas can be achieved if the indication for operation is obvious.