脑干神经细胞胶质瘤的诊断及外科治疗.docVIP

脑干神经节细胞胶质瘤的诊断及显微神经外科手术治疗 王永刚，吴震，张力伟，贾桂军，肖新如，张俊廷#，王忠诚 （首都医科大学附属北京天坛医院神经外科， 北京 100050） 摘要：目的　总结脑干神经节细胞胶质瘤的临床表现、影像学特点及治疗, 为提高该病的诊断和治疗提供有效的帮助。方法　回顾性分析17年间在我院经手术及病理证实的10例脑干神经节细胞胶质瘤病例。行肿瘤近全切除者6例，大部切除者2例，部分切除者2例。2例术后辅助放疗。结果　所有病例病理诊断均为神经节细胞胶质瘤，随访3个月至12年，2 例失访。其余8例中7例存活，未见肿瘤复发，KPS评分70-100分，平均87.1分。结论　显微神经外科手术是脑干神经节细胞胶质瘤的首选治疗方法，手术应主要切除突出到脑干外及脑干内相对表浅的肿瘤。该病预后较好，后组颅神经麻痹是其主要术后并发症。 关键词：:神经节细胞胶质瘤；脑干；显微神经外科手术 The diagnosis and surgical treatment of ganglioglioma in brain stem. Wang Yonggang, Wu Zhen, Zhang Liwei, Jia Guijun, Xiao Xinru, Zhang Junting, Wang Zhongcheng Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China Abstract: Objective To evaluate the clinical findings, neuroradiology and microneurosurgery of intracranial gangliogliomas in brain stem. Methods Ten patients with brain stem ganglioglioma were treated surgically in our neurosurgical center and their medical records were analyzed retrospectively. Subtotal resection of the tumor was achieved in six cases; Large partial resection in two cases and small partial resection in another two cases; 2 cases were followed with postoperative adjunctive radiotherapy. Results The pathology of all the ten cases was ganglioglioma . The follow-up time was 3 months to 12 years. Except the lost two cases, seven patients were alive, postoperative KPS scale ranged from 70 to 100 ( Average 87.1). Conclusion Surgical resection is the mainstay of treatment for the ganglioglioma growing in the brain stem. In order to avoid significant post-surgical neurological deficit, subtotal resection of exophytic components of the tumors is the main option of surgery. The prognosis of brain stem ganglioglioma is good. Posterior cranial nerve palsy is the most common complication of the surgery. Key words: Ganglioglioma; Brain stem; Microneurosurgery. # 通讯作者：张俊廷 发生在脑干的神经节细胞胶质瘤十分少见，术前诊断较为困难，手术风险大，术后易出现神经功能障碍。本文总结1992年10月至2009年11月年在我院脑干颅底病房收治的10例脑干神经节胶质瘤病人临床资料，结合文献对生长在脑干的神经节细胞胶质瘤的临床表现、诊断及治疗方法进行回顾性分析。 资料与方