目的 探讨电化学疗法(EChT)对肝海绵状血管瘤(CHL)的治疗价值。方法 应用EChT在剖腹下治疗8例CHL，17个瘤灶。1例合并结节性肝硬变，5例为多发性CHL，14个瘤灶。结果 治疗过程中肝出血量均不超过20 ml。术后无胆漏、腹腔内出血、黄疸、气体栓塞等并发症产生。治疗后随访5～7年，无1例出现瘤灶复发。结论 EChT是治疗CHL的安全而有效的新方法，适合伴有背景肝病的CHL和多发性CHL的治疗，且易于在基层医院推广。
【摘要】 目的 探讨治疗肝尾状叶巨大海绵状血管瘤的外科手术方法。方法 通过1 例肝尾状叶巨大海绵状血管瘤外科手术治疗体会并结合文献复习,分析肝尾状叶解剖及影像学特点,探讨外科手术方法。结果 肝尾状叶巨大海绵状血管瘤因肝尾状叶特殊的解剖特点,安全并有效的肝全尾叶血管瘤切除是治疗这类疾病的有效治疗方法。结论 选择合适的手术径路是关键,熟练并精细地解剖、默契的手术配合可以安全切除肝尾状叶巨大海绵状血管瘤。
ObjectiveTo discuss multislice spiral CT (MSCT) features and pathologic basis of the cavernous hemangioma of mediastinum, and further improve the diagnostic accuracy with CT. MethodsWe collected 4 cases of cavernous hemangioma in mediastinum from November 2008 to November 2013. All patients underwent MSCT examination of plain scan and enhanced-contrast scan. The CT manifestations of cavernous hemangioma in mediastinum were observed. The correlation of the CT imaging findings with pathology features was analyzed retrospectively. ResultsTwo of the 4 lesions were located in the anterior mediastinum and the other 2 in the posterior mediastinum. On plain scan, 2 lesions showed homogeneous density, and 2 had heterogeneous density. Vessels could be observed in all lesions on enhanced-contrast CT imaging. ConclusionCavernous hemangioma in mediastinum is often located in the anterior and posterior mediastinum. Calcification and vessels in lesions are its imaging characteristics. Multislice spiral enhanced CT can accurately reflect the characteristics and pathological basis, providing more important information for diagnosis.
ObjectiveTo explore the clinical features and surgical treatment effects of cavernous angioma in the temporal lobe secondary to epilepsy.Method38 cases of patients with cavernous angioma in the temporal lobe secondary to epilepsy were collected in Department of Neurosurgery of Wuhan Brain Hospital from Jan. 2010 to Jan. 2019. There were 17 males and 21 females, their age range from 8 to 57 years, average (40.05±14.64) years. Their illness duration ranged from 1 to 10 years, average (1.25±2.19) years. The clinical manifestations showed complex partial seizure in 7 cases, partial-secondary-generalized seizure in 8 cases, and generalized tonic-clonic seizure in 23 cases. All the patients underwent CT/MRI and long-term VEEG monitoring examination. Based on their results of clinical manifestations, combined with CT/MRI and VEEG results, all the patients underwent microsurgical cavernous angioma resection under the guidance of ECoG. If necessary, anterior temporal lobectomy or coortical coagulation should be added. The surgical effect were evaluated by Engel levels by followed up.ResultsThe postoperative pathology confirmed the diagnosis of cavernous angioma. The follow-up of 1 ~ 9 years showed the seizure disappeared in 36 cases, and bad effect in 2 cases. The total surgical effect rate was 94.74% (36/38).ConclusionsTo the patients of cavernous angioma in the temporal lobe secondary to epilepsy, the glial scar and hemosiderin sedimentary zone should be resected after resecting the lesion, and if necessary, anterior temporal lobectomy or cortical coagulation could be added. If it is difficult to locate the lesion, neuronavigation and ultrasound can be used, and the postoperative curative result is satisfactory.
ObjectiveTo explore the clinical efficacy of transcatheter arterial embolization or transcatheter arterial embolization combined with percutaneous transhepatic sclerotherapy injection for hepatic cavernous hemangioma with different blood supply. MethodsEighty-six patients with hepatic cavernous hemangioma with different blood supply received femoral artery pingyangmycin iodized oil embolization or transcatheter arterial embolization combined with percutaneous transhepatic injection of pingyangmycin iodized oil embolization from February 2004 to April 2013. ResultsForty-five cases (52.3%) of tumor decreased by over 50%; 26 (30.2%) decreased by about 20% to 50%; 11 (12.8%) decreased by less than 20%; and 4 (4.7%) had no significant change in the tumor diameter. Patients did not have serious complications. ConclusionThe effect of individualized intervention for hepatic cavernous hemangioma with different blood supply is obvious, and it is a safe and effective therapeutic method.
The authors suggest that occlusion of blood flow to the whole liver is not necesarily a routine procedure in surgical removal of giant cavernous hemangioma in the 8th segment of liver. An occlusion tape can be placed around the finferior vena cava inadvance. Separtion of inferior vena cava between the diaphragm and the upper surface of liver sometimes is difficult, so that placement of the tape may fail. The procedure which we performed in four patients was intermittent occlusion of blood flow at the first hepatic hilum at room temperature during dissection and removal of the tumor en bloc. This operative method is simple and safe as compared with that of resection of the 8th segment of liver.