儿童脊髓内肿瘤的显微外科治疗

Microsurgery for the treatment of intramedullary tumors in children

目的总结儿童髓内肿瘤的病理特点、显微手术和治疗效果，并进行探讨。方法81例儿童脊髓内肿瘤均经手术切除和病理证实，对手术治疗的效果进行回顾性分析。结果儿童髓内肿瘤以星形细胞瘤24例（29．6％）、室管膜瘤13例（16．0％）和表皮样囊肿11例（13．6％）为多见，不同的病理类型的肿瘤，切除率不同。放疗用于高度恶性的肿瘤。椎板复位术可以有效地减少脊柱畸形的发生率。结论大多数的髓内肿瘤组织学上为低级别星形细胞瘤（Ⅰ～Ⅱ级）、室管膜瘤和胚胎残余组织肿瘤，积极手术切除能够获得满意的疗效。

Objective To investigate the results of microsurgieal treatment for intramedullary tumors in children. Methods Eight-one children with intramedullary tumors which were proved by histopathologieal examination underwent microsurgical treatment in this institute. The clinical data including the pathological types, treatment, and long term results were retrospectively analyzed. Results Astrocytomas（29. 6%）, ependymomas（16. 0%）, and epidermoids（13. 6%） were the most common pathological types in pediatric intramedullary tumors. Moreover, the pathological classification was related to resection rate. Radiotherapy was applied to the malignant tumors after operation. Thirty-nine patients were followed up for an average of 6 years, 74. 3% of these patients got the functional recovery of grade Ⅰ or Ⅱ according to McCormick grading system. The long-term follow-up showed that laminoplasty could effectively decrease the incidence of spinal deformities after operation. Conclusions Microsurgieal treatment can obtain good results for children with intramedullary tumors.