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目的探讨毗邻脑干的大型实质性血管母细胞瘤的外科治疗方法。方法回顾性分析2例经术后病理证实的毗邻脑干的实质性血管网织细胞瘤患者的临床资料,瘤体最大径分别为5.1 cm和6.5 cm。结果 1例患者通过1次术前栓塞后,在术中历经23 h全切肿瘤;另1例患者通过2次术前栓塞,术前MRI与DSA三维影像融合,术中神经导航,历经5 h全切肿瘤。术后2例患者均未发生神经功能障碍。结论对于巨大型实质性血管母细胞瘤,术前有效的供血动脉栓塞是有必要的,术前MRI与3D-DSA三维影像动态融合可以减少手术创伤,术中利用娴熟的显微外科技术分流脑干和肿瘤的界面力争全切。
Objective To investigate the surgical treatment of large, substantial hemangioblastoma adjacent to the brain stem. Methods The clinical data of 2 patients with substantial hemangiocytoma adjacent to the brain stem confirmed by postoperative pathology were retrospectively analyzed. The maximum diameter of tumor was 5.1 cm and 6.5 cm, respectively. Results One patient underwent preoperative embolization and the tumor was completely resected at 23 h after surgery. The other patient underwent preoperative embolization twice, preoperative MRI and DSA three-dimensional image fusion, intraoperative nerve navigation, after 5 h Totally cut the tumor. No neurological dysfunction occurred in 2 patients after operation. Conclusions The preoperative effective arterial embolization of blood supply is necessary for the treatment of giant solid hemangioblastoma. The dynamic fusion of preoperative MRI and 3D-DSA can reduce the surgical trauma. Intraoperative use of skilled microsurgical shunt Dry and tumor interface and strive to cut all.