脊髓髓内肿瘤的显微外科治疗——附53例临床分析

Microsurgical Management of Intramedullary Spinal Cord Tumors:Report of 53 Cases

背景与目的:脊髓髓内肿瘤作为神经外科的一种常见疾病被广大神经外科医生所重视,其治疗效果随着显微外科技术的发展在近几年得到了较大的提高。通过总结我科近一年来收治的脊髓髓内肿瘤患者的治疗情况探讨治疗经验并评估其效果。方法:对我科2006～2007年经手术治疗的53例脊髓髓内肿瘤患者进行回顾性研究。对肿瘤病理类型、肿瘤部位、临床症状及体征、辅助检查、手术切除程度、术后疗效进行分析。结果:本组室管膜瘤49.1%,星形细胞瘤30.2%,脂肪瘤15.1%,血管母细胞瘤5.7%,本组总全切率为56.6%,次全切除率为30.2%,部分切除或活检率为13.2%,室管膜瘤全切率可达96%,无手术死亡患者。结论:通过早期诊断及早期显微手术治疗脊髓髓内肿瘤可以明显减轻患者症状,改善其生活质量,特别是对室管膜瘤及血管母细胞瘤大都可做到全切并且少有复发。

BACKGROUND ＆ OBJECTIVE： Intramedullary spinal cord tumors are common neurosurgical diseases. Prognosis has improved because of advances made in microsurgical techniques. In this article, we evaluated the effect of the microsurgical management of intramedullary spinal cord tumors. METHODS ： Fiftythree cases of intramedullary spinal cord tumors treated in our department in one year were analyzed retrospectively. RESULTS： Among the 53 cases, ependymomas were the most common tumors（49,1%）. Astrocytoma was in 30.2%, lipoma in 15,1% and hemangoblastoma in 5.7%, There was no operation-related death. CONCLUSIONS： Early diagnosis and microsurgical treatment can palliate symptoms and improve the quality of life. Most of ependymomas and hemangoblastomas can be cured solely by surgery.