臂丛神经鞘膜瘤的手术治疗

Surgical treatment of schwannomas in brachial plexus

目的 探讨臂丛神经鞘膜瘤的显微外科手术治疗。方法 1975年至今共收治臂丛神经鞘膜瘤17例,源自臂丛上干7例,中干8例,C_(5、6)神经根1例,外侧束1例。14例行显微外科手术切除肿瘤,3例曾在外院误将肿瘤与神经于一并切除,行神经移植修复术。结果 14例术后神经功能正常,随访6个月至10年,无1例复发。3例误将臂丛上干切除行神经缺损修复者,术后均有不同程度的功能恢复,效果良好。结论 臂丛神经鞘膜瘤在手术显微镜下逐层剥离包膜,完整切除瘤体,保护好神经干,均能获得较满意的疗效。

Objective To investigate microsurgical removal of schwannoma in the brachial plexus. Methods Seventeen patients with schwannomas of brachial plexus were included for 1975 to 2003. There were 7 in the superior trunk of brachial plexus, 8 in the middle trunk, 1 in the 5th and 6th cervical nerve root and 1 in the lateral cord. Microsurgical removal of the tumors was done in 14 patients. The other 3 patients were referred to our hospital for nerve grafting because both the tumors and nerve trunk were resected mistakenly. Results Over a peried of 6 months to 10 years follow-up, the 14 patients had normal function postoperatively without recurrence. The referred 3 patients had Variable functional restoration and a good result was obtained. Conclusion Detachment of the envelope of schwannoma by layers under the microscope and keep the nerve trunk intact can achieve satisfactory results.