中文摘要
中文摘要
目的
探究并总结吲哚菁绿（Indocyanine Green,ICG）荧光造影技术在高颈段脊髓血管母细胞瘤（Hemagioblastomas,HBs）显微外科手术中的临床应用价值。
方法
回顾性分析南昌大学第二附属医院神经外科2012年2月至2016年4月收治的8例高颈段脊髓HBs患者的临床资料。8例患者均采用后正中入路行椎管内肿瘤切除术，剪开硬脊髓显露肿瘤及瘤周血管等组织后一同置于具有荧光观测系统的Petero手术显微镜下行ICG荧光造影。根据血管的荧光显影时差帮助辨认肿瘤供血动脉、引流静脉及了解相应血管分支的位置、走向、数目等。仔细辨认明确后先电凝并离断肿瘤供血动脉，离断后见肿瘤张力减低、色泽变淡，随后紧贴瘤体表面沿瘤体-脊髓界面间的纤维水肿带钝锐性分离肿瘤组织，最后再离断引流静脉，将肿瘤予以整块切除。术前、术后1周、术后3月均采用McCormick脊髓功能状态分级与JOA评估分数评估脊髓功能；术后1周、术后3月复查颈脊髓MRI，术前后影像比对，进一步评估肿瘤切除程度。
结果
根据荧光显影时差，荧光图像依次可以观察并记录到肿瘤的动脉期、毛细血管期、静脉期。首次荧光造影后位置表浅的供血动脉与引流静脉均完全显影，位置深、脊髓组织覆盖的血管显影效果欠佳。8例患者均未出现ICG的过敏不良事件，肿瘤的供血动脉与引流静脉均实现准确辨认与离断，术中未出现难以控制的出血，显微镜下肿瘤组织均整块切除。术后均无呼吸障碍、吞咽异常、肢体肌力下降等脊髓损伤并发症。肿瘤组织术后病理诊断为HBs。术后1周复查颈脊髓MRI提示肿瘤获得全切，术后3月未见肿瘤复发。术后患者的JOA评分、McCormick脊髓功能状态分级较术前均不同程度上升。
结论
高颈段脊髓HBs通过显微外科手术可予完全切除并获得良好的预后。ICG 荧光造影技术可以直视地观察血流走向，帮助术者辨认脊髓HBs的供血动脉与引流静脉，也有助提高肿瘤-脊髓边界的辨识度。术中先逐步离断肿瘤的供血动脉，有助于将瘤体从正常脊髓中精准分离，有效防止术中不可控的活动性出血，
中文摘要
有效提高了高颈段脊髓HBs手术的全切率与安全性。毛囊炎怎么去除
关键词：血管母细胞瘤；高颈段脊髓；吲哚菁绿；显微外科手术
Abstract
ABSTRACT
Objective有你真好作文
背影图片女
To explore and summarize the value of indocyanine green angiography in the microsurgery of super cervical spinal cord hemangioblastoma.
Methods
Date from the medical records of8patients with super cervical spinal cord hemangioblastoma microsurgieally treated from February2012to April2016were reviewed.The tumors of8patients were rected using the Petero fluorescence microscope,the surgery was performed using posterior midline approach to remove the tumors.In the process of microsurgery,application of indocyanine greenangiogr-aphy,The location,direction and number of tumor feeding arteries and draining veins were determined according to the fluorescence development.Carefully identify clear after the first coagulation and breaking away from the tumor feeding artery,after tranction of tumor,reduce the te
nsion of the color fades,then clo to the tumor body surface tumor and spinal cord edema along the fiber interface with a blunt sharp paration of tumor tissue,finally breaking away from the venous drainage,will be the whole tumor rection.The spinal cord function was assd by McCormick spinal cord functional status before operation,1weeks after operation and3months after surgery.MRI of cervical spinal cord was reviewed for1week after operation and 3months after surgery.image contrast before and after surgery to evaluate the extent of tumor rection.w我的世界
Results
No contrast agent-related adver events occurred in8patients during procedure.all the patients profited indocyanine green angiography and avoid disastrous intraoperative bleeding and hemostasis-related manipulative injury to the spinal cord.Postoperative pathological diagnosis:8patients had hemangioblasto-ma.McCormick grade was compared between pre-operation and post-operatio, neurological conditions were improved in8patients.post-operative reexamine results confirmed the total rection of the tumor and achieved ideal therapeutical effect.
Abstract
Conclusions
郑俊日
Super cervical spinal cord hemangioblastomacan be completely rected by microsurgery and obtain a good prognosis.Indocyanine green angiography is contribute to identify the tumor feeding artery,the draining vein and the boundary of the tumors.Achieving accurate treatment can reduce intraoperative bleeding and prevent spinal cord injure.This technique improves the safety and effectiveness of surgical treatment of super cervical spinal cord hemangioblastoma.
Keywords:hemangioblastoma;super cervical spinal cord;indocyanine green; microsurgery
目录
目录
第1章前言 (1)
第2章材料与方法 (2)
2.1材料 (2)
2.1.1一般资料 (2)
2.1.2主要临床表现 (2)
2.1.3影像学检查 (2)
2.1.4术前McCormick脊髓功能状态分级与JOA评分 (2)
2.2方法 (3)
户字开头的成语2.2.1术前准备与暴露方式 (3)
2.2.2术中ICG荧光造影的具体运用方法 (4)
2.2.3手术整体切除肿瘤的具体方法 (4)
第3章结果 (6)
3.1术中ICG荧光造影情况 (6)
越南节日3.2肿瘤切除程度 (6)
3.3并发症与术后症状改善情况 (7)
3.4病理结果 (7)
3.5术后McCormick脊髓功能状态分级与JOA评分 (7)
3.6典型病例 (7)
3.6.1典型病例1 (7)
3.6.2典型病例2 (9)
第4章讨论 (12)
4.1概述 (12)
4.2影像学诊断与临床治疗 (12)
4.3ICG荧光造影技术在手术中的运用 (14)
独特的意思第5章结论 (18)
致谢 (19)
参考文献 (20)
发表论文和参加科研情况说明 (23)
综述 (24)
