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Operation on hypervascular acoustic tumor
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF NEUROSURGERY
- Issue:
- 4
- DOI:
- 10.3760/j.issn:1001-2346.2007.04.002
- Key Word:
- 血管造影术;富含血管的听神经瘤;控制性低血压;显微外科手术
Abstract： 目的 探讨富含血管的听神经瘤的手术治疗.方法 复习20年(1975-1995)手术治疗单侧听神经瘤90例,其中4例为富含血管的听神经瘤(HAT),与86例非富含血管的听神经瘤(NHAT),做回顾性分析,据临床表现、放射学检查、手术所见做比较.结果 HAT较NHAT年轻(28±10与54±17岁)(P＜0.01),MRI显示HAT为实质性,无肿瘤囊变,多数较NHAT为大(P＜0.05);MRI示HAT有多个代表较大引流静脉的流空效应;经皮股动脉、椎动脉造影显示HAT有广泛的肿瘤着色及早期引流静脉的充盈,并证实由椎基动脉供血.过去文献报道认为以分期手术为宜.作者在控制性低血压麻醉下,成功地完成了4例HAT的切除术,未输血,术后无明显伤残.结论 HAT是一种实质性大型肿瘤,出现于青年期,血管造影能够提供特征性发现.MRI能显示肿瘤表面的流空效应而确诊.采用控制性低血压麻醉有望能一期全切除肿瘤.
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