延髓肿瘤的外科临床表现(附68例临床报告)

Clinical manifestations of medulla oblongata tumors in microsurgery (including 68 cases analysis )

目的：分析68例不同性质延髓肿瘤临床表现，有助于早期诊断，早期治疗。万法：全面分析68例延髓肿瘤临床症状与体征、神经放射学特征，评估术前呼吸循环功能，并结合术中所见和术后病理诊断，对不同性质肿瘤进行对比研究。结果：延髓肿瘤以后组预神经功能受累最为多见。良性肿瘤生长较缓慢，常见肿瘤巨大而临床症状轻微，很少发生明显呼吸循环功能改变。出血性肿瘤如海绵状血管瘤常突然发病，症状突然加重，表现出呼吸、循环改变，恶性度高的胶质瘤，病情进展迅速，临床症状较重。结论：延髓肿瘤早期症状元明显特异性，如果出现后组颅神经功能障碍及长束征或特发呼吸功能障碍者，宜进一步行MRI检查以明确诊断。

Obect To study the clinical and radiological features of 68 cases of medulla oblongata tumors. Method Retrospective analysis of 68 cases of medulla oblongata tumors was performed to study clinical symptoms and physical signs,neuro-radiologic charactors, preoperative functions of respiration and circulation combined with operation, histopathalogy of tumors. Result Neurological deficits of caudal cranial nerves and long tracts were the main presentation of medulla oblongata in our series. Early manifestations were slight and non specific in benign tumor patients. The failure of respiratory and circulatory function was rare in eary stage except for bleeding of the tumor such as angioreticuloma or severe malignant tumors. MRI is an useful and effective method to diagnosis. Conclusion Typical neurological deficits of caudal cranial nerves and MRI are benefits for eariy diagnosis.