术前栓塞联合显微手术治疗实质性小脑血管母细胞瘤的临床效果[摘要]目的探?分析术前栓塞联合显微手术治疗实质性小脑血管母细胞瘤的临床效果。方法将2010年4月～2016年4月武汉大学人民医院神经外科收治的46例小脑实质性血管母细胞瘤患者作为研究对象，根据不同的治疗方案将其分为术前栓塞组（22例）和对照组（24例）。记录两组病例的一般资料和相关手术指标，分析术前栓塞的安全性及有效性。结果术前栓塞组14例达到完全栓塞，其中1例发生栓塞并发症（脑出血），6例大部分栓塞，2例部分栓塞。其中20例显微镜下全切，且未损伤脑干及邻近正常组织结构，2例因肿瘤同脑干粘连紧密，未强行全切。对照组显微镜下全切18例，6例因肿瘤出血凶猛严重影响手术视野，未能全切，其中4例切除90%，2例切除80%，且不同程度地损伤周边正常脑组织。术前栓塞组手术时间[（6.79±1.53）h]、术中出血量[（459.24±25.17）mL]、输血量[（250.00±81.35）mL]均短于或少于对照组[（8.11±1.36）h、（938.62±30.93）mL、（472.00±132.18）mL]，差异均有统计学意义（P<0.05）。结论术前栓塞联合显微手术治疗实质性小脑血管母细胞瘤能有效缩短手术时间，减少术中出血量和输血量，提高患者的预后，是一种安全、可靠、有效的辅助治疗手段，具有较高的临床应用价值。[关键词]术前栓塞；显微手术；实质性；小脑；血管母细胞瘤；效果[]R739.41[文献标识码]A[]1673-7210（2016）12（b）-0068-04ClinicaleffectsofpreoperativeembolizationcombinedwithmicrosurgeryinthetreatmentofsubstantivecerebellarhemangioblastomaZHANGXiangyangHUANGShulanDepartmentofNeurosurgery，RenminHospitalofWuhanUniversity，HubeiProvince，Wuhan430060，China[Abstract]ObjectiveToinvestigateandanalyzetheclinicaleffectsofpreoperativeembolizationcombinedwithmicrosurgeryinthetreatmentofsubstantivecerebellarhemangioblastoma.MethodsAtotalof46patientswithsubstantivecerebellarhemangioblastomaadmittedtoDepartmentofNeurosurgery，RenminHospitalofWuhanUniversityfromApril2010toApril2016wereselectedasresearchobjects，andtheyweredividedintopreoperativeembolizationgroup（22cases）andcontrolgroup（24cases）accordingtodifferenttreatmentmethods.Thegeneraldataandsurgery-relatedindicatorsofthetwogroupswererecorded，andthesecurityandeffectivenessofpreoperativeembolizationwereanalyzed.ResultsInpreoperativeembolizationgroup，therewere14patientswithcompleteembolization，including1patientwiththecomplicationofcerebralhemorrhage，6patientswithmostembolizationand2patientswithpartialembolization.20patientsgotcompleteresectionwithmicroscope，withoutdamagingbrainstemandadjacentnormaltissuesandstructures，2patientsgotmostresectionforthecloseadhesionoftumourandbrainstem.Inthecontrolgroup，18patientsgotcompletelyresectionwithmicroscope，6patientsgotpartialresectionbecauseoftheserioushemorrhageaffectingthesurgeryfield，amongwhom，4patientsgot90%resection，2patientsgot80%resection，withvaryingdegreesofdamagetothesurroundingnormalbraintissue.Theoperativetime[（6.79±1.53）h]，intraoperativebloodloss[（459.24±25.17）mL]andtransfusionblood[（250.00±81.35）mL]inthepreoperativeembolizationgroupwereallshorterorlessthanthoseofcontrolgroup[（8.11±1.36）h，（938.62±30.93）mL，（472.00±132.18）mL]，thedifferenceswerestatisticallysignificant（P<0.05）.ConclusionPreoperativeembolizationcombinedwithmicrosurgeryinthetreatmentofsubstantivecerebellarhemangioblastomacaneffectivelycutdowntheoperativetime，reducetheintraoperativebloodlossandtransfusionbloodandimprovetheprognosisofpatients，whichisasecure，reliableandeffectivemethodofadjuvanttherapy，withhighclinicalapplicationvalues.[Keywords]Preo...