目的探讨延髓背侧血管母细胞瘤的术前、术中以及术后处理要点,降低并发症及病死率。方法回顾性分析经显微手术治疗的14例延髓背侧血管母细胞瘤患者的临床资料。结果 14例患者中2例为多发,分别位于颈2以及颈4水平脊髓背侧,4例于延髓背侧和肿瘤之间可见薄层囊变间隙。肿瘤最大径3～6.5cm。所有患者术前、术后均行MRI检查,9例术前行脑血管造影检查,6例行术前肿瘤供血动脉栓塞。所有患者均在显微镜下行肿瘤切除术,死亡3例,其中围手术期因严重灌注压突破死亡1例,死于晚期呼吸衰竭2例。其余患者术后症状明显改善。结论术前明确诊断对于手术方案的制定十分重要,术前行肿瘤供血动脉栓塞可减少术中严重并发症,术中显微技术熟练应用以及术后人工辅助呼吸可明显改善患者预后。 Objective To investigate the preoperative, intraoperative and postoperative management of medullary medullary hemangioblastoma and to reduce the complications and mortality. Methods The clinical data of 14 patients with medullary dorsal hemangioblastoma treated by microsurgery were analyzed retrospectively. Results Of the 14 patients, 2 were multiple. They were located on the dorsal side of the neck 2 and the neck 4, respectively. Four cases showed lamellar cystic degeneration between the dorsal medulla oblongata and the tumor. The largest tumor diameter 3 ~ 6.5cm. All patients underwent MRI examination before operation and after operation. Cerebral angiography was performed in 9 cases preoperatively and in 6 cases before operation. All patients were undergone tumor resection under microscope, 3 patients died, of which 1 patient died of perinatal respiratory failure due to severe perfusion pressure breakthrough in perioperative period. The remaining patients postoperative symptoms improved significantly. Conclusion The preoperative diagnosis is very important for the development of surgical plans. Preoperative tumor arterial embolization can reduce serious intraoperative complications. The intraoperative application of microsurgical techniques and postoperative artificial ventilation can significantly improve the prognosis of patients.