CAJ | 학술논문

目的探讨术前线段栓塞在手术切除小脑和高颈髓实性血管母细胞瘤( hemangioblastoma, HB)中的临床效果. 方法将72例小脑和高颈髓实性HB行手术切除患者依据手术方式分为术前栓塞组32例和对照组40例,术前栓塞组采用局部麻醉或全身麻醉,成功将线段送至病变处供血动脉进行栓塞,后于1~7d内行肿瘤切除术;对照组仅行肿瘤切除术. 对比观察两组手术切除时间、术中失血量、总输血量、手术并发症及预后情况. 结果术前栓塞组中完全栓塞10例,大部分栓塞12例,部分栓塞10例. 术前栓塞组手术切除时间短于对照组,术中失血量、总输血量均少于对照组,手术并发症发生率低于对照组,临床预后良好度优于对照组,差异均有统计学意义( P<0. 05或P<0. 01). 结论术前线段栓塞小脑和高颈髓实性HB可缩短手术切除时间,减少术中出血和输血量,较少手术并发症,提高临床预后.
목적 탐토술전선단전새재수술절제소뇌화고경수실성혈관모세포류( hemangioblastoma, HB)중적림상효과. 방법 장72례소뇌화고경수실성HB행수술절제환자의거수술방식분위술전전새조32례화대조조40례,술전전새조채용국부마취혹전신마취,성공장선단송지병변처공혈동맥진행전새,후우1~7d내행종류절제술;대조조부행종류절제술. 대비관찰량조수술절제시간、술중실혈량、총수혈량、수술병발증급예후정황. 결과 술전전새조중완전전새10례,대부분전새12례,부분전새10례. 술전전새조수술절제시간단우대조조,술중실혈량、총수혈량균소우대조조,수술병발증발생솔저우대조조,림상예후량호도우우대조조,차이균유통계학의의( P<0. 05혹P<0. 01). 결론 술전선단전새소뇌화고경수실성HB가축단수술절제시간,감소술중출혈화수혈량,교소수술병발증,제고림상예후.
Objective To investigate the clinical effect of preoperative embolization with silk segment on solid hemangioblastoma ( HB) in cerebellum and high cervical spinal cord by surgical ablation. Methods A total of 72 pa-tients with solid HB in cerebellum and high cervical spinal cord by surgical ablation were divided into preoperative embo-lization group (n=32) and control group (n=40) according to surgical methods. The preoperative embolization group was treated with local or general anesthesia, the feeding arteries of tumor were successfully embolized by silk segment, and then the tumor resection was performed within the following 1-7 d. The control group underwent tumor resection a-lone. The operative time, intraoperative blood loss volume, total volume of blood transfusion, incidence rate of complica-tions and prognosis were observed and compared in the two groups. Results In preoperative embolization group, there were 10 patients with complete embolization, 12 patients with nearly complete embolization and 10 patients with partial embolization. Compared with those in the control group, in preoperative embolization group, the operative time was shor-ter;the volumes of intraoperative blood loss and total blood transfusion were less;the incidence rate of complications was lower;clinical prognosis was better; the differences were statistically significant in the two groups ( P <0. 05 or P <0. 01). Conclusion The preoperative embolization with silk segment on solid hemangioblastoma (HB) in cerebellum and high cervical spinal cord by surgical ablation can shorten the operative time, reduce volumes of intraoperative blood loss and total blood transfusion, decrease incidence rate of complications and improve clinical outcomes.