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目的探讨治疗原发椎管内血管外皮细胞瘤的有效手段。方法回顾性分析23例原发椎管内血管外皮细胞瘤的临床表现、影像学特征、治疗方法及预后。结果肿瘤次全切除11例,次全切除加放疗4例,全部切除5例,全部切除加放疗3例。对2例肿瘤全部切除的病人同时进行了内固定。随访19例,肿瘤复发率为68%(13/19),转移率为21%(4/19)。结论整块切除肿瘤和受累的硬脊膜,可减少术中出血和术后复发。若病变较大需分块切除,术前应先栓塞。未能全切的病人需辅助放疗。椎体或椎弓根破坏明显的病人尽可能同时行内固定术。肿瘤起源于硬脊膜的病人预后较好。术后长期随访是必要的。
Objective To explore the effective treatment of primary intracranial hemangiopericytoma. Methods The clinical manifestations, imaging features, treatment and prognosis of 23 patients with primary intracranial hemangiopericytoma were analyzed retrospectively. Results Subtotal resection in 11 cases, subtotal resection and radiotherapy in 4 cases, all resected in 5 cases, all excision and radiotherapy in 3 cases. Two patients with complete resection of the tumor were treated simultaneously with internal fixation. Totally 19 cases were followed up, the tumor recurrence rate was 68% (13/19) and the metastasis rate was 21% (4/19). Conclusion The lump resection of the tumor and the affected dura can reduce intraoperative bleeding and postoperative recurrence. If the lesion needs to be divided block, preoperative embolization should be. Patients who have not been fully cut need adjuvant radiotherapy. Vertebral body or pedicle obvious destruction of patients as much as possible while internal fixation. Patients with tumors that originate in the dura show a better prognosis. Postoperative long-term follow-up is necessary.