%0 Journal Article
%T 脑干海绵状血管瘤的临床表现及预后分析
%A 孙季冬
%A 刘翼
%A 贺民
%A 孙鸿
%A 游潮
%J 华西医学
%P 355-358
%D 2011
%X 【】　目的　探讨脑干海绵状血管瘤患者临床表现及影响预后的相关因素。　方法　回顾分析2008年9月-2010年9月27例脑干海绵状血管瘤患者临床资料。　结果　20例（74.1%）患者CT显示出血及血肿。急性或突然神经功能废损22例，渐进性功能障碍15例，病情平稳4例。显微手术12例，放射治疗6例，保守观察9例。长期随访25例，2例再次出血，无新发病灶，无患者死亡。手术组患者年龄（P<0.05）、术前病情严重程度（P<0.05）与术后KPS评分相关。非手术组不良预后评分与患者高龄及再出血有关。　结论　展神经麻痹和面瘫患者功能恢复较差。年龄、术前病情严重程度及手术时机影响患者预后，术中全切病灶对复发和并发症发生起主要作用，如何处理合并发生的静脉畸形有待讨论。立体定向放射治疗明显降低再出血风险，但其适应证尚有争议。【Abstract】　Objective　Todiscusstheclinicalmanifestationsandprognosticfactorsofbrainstemcavernoushemangioma.　Methods　Basedontheliterature,theclinicaldataof27patientshavingbrainstemcavernoushemangiomafromSeptember2008toSeptember2010werereviewedandanalyzed.　Results　Twentypatients(74.1%)presentedwithhemorrhageandhematomainCTscan.Acuteorsuddenneurologicaldeteriorationoccurredto22patients,progressivein15andstablein4.Twelvepatientsunderwentsurgicalremovalofthelesion;6underwentradiosurgery;and9continuedwithconservativemanagement.Twenty-fivepatientswerefollowedup.Twopatientshadrehaemorrhagia.Therewerenodenovolesionsordeath.TheriskfactorsindicativeofapossiblepoorpostoperativeKPSscoreintheoperativegroupincludedage(P<0.05)andtheinitialclinicalcondition(P<0.05).Inthenon-operativegroup,oldageandrehaemorrhagiawereobviouslyrelatedtothepooroutcome.　Conclusions　Patientswithabducensandfacialpalsyhavepoorfunctionalrecovery.Age,theinitialclinicalconditionandtimingofoperationarethemajorfactorscorrelatedtosurgicaloutcome.Thefactorthataffectsrecurrenceandtheoccurrenceofcomplicationsiscompleteresectionduringtheoperation.Howtodealwiththeconcomitantvenousmalformationshouldbefurtherstudied.Theindicationsforstereotacticradiosurgeryarestillcontroversial,althoughithasconferedareductionintheriskofrehaemorrhagia.
%K 脑干
%K 海绵状血管瘤
%K 海绵状血管畸形
%K 预后
%U http://www.hxyxqk.com.cn/oa/DArticle.aspx?type=view&id=201103011