脊髓髓内肿瘤22例外科治疗策略

Surgical treatment of intramedullary spinal cord tumors:A study of 22 cases

目的探讨髓内肿瘤的手术治疗方法与疗效。方法回顾性分析22例髓内肿瘤手术治疗的临床与随访治疗,并进行文献复习。结果肿瘤完全切除12例(室管膜瘤10例,星形细胞瘤和血管网织细胞瘤各1例);次全切除7例(星形细胞瘤、皮样囊肿和多形性胶质母细胞瘤各2例,累及延髓下部室管膜瘤1例);部分切除3例(脂肪瘤2例和多形性胶质母细胞瘤1例)。术后近期疗效:治愈10例,稳定、好转7例,加重2例,死亡3例。结论根据肿瘤部位、性质、体积、电生理监测结果制定个体化治疗方案,具有较好的治疗效果,应积极开展髓内肿瘤的早期显微外科治疗。

Objective To investigate the Methods and outcomes of surgical treatment of intramedullary spinal cord tumors.Methods Twenty-two cases of intramedullary spinal cord tumors were analyzed retrospectively and related literature was reviewed.Results Complete tumor resection was achieved in 12 cases,including 10 cases of ependymoma,1 astrocytoma and 1 hemangioblastoma.Subtotal resection was achieved in 7 cases,including 2 cases of astrocytoma,2 cases of dermoid cysts,2 cases of glioblastoma multiforme and 1 ependymoma.Partial resection was achieved in 3 cases,including 2 cases of lipoma and 1 glioblastoma multiforme.Recent postoperative outcomes were as follows：10 cases were cured,7 were recovered and stable,2 were deteriorated and 3 were dead.Conclusions Individualized treatment should be made based on location,nature,size and electrophysiological monitoring Results of the tumors.Favorable outcomes could be achieved in most cases.Early microsurgical treatment of intramedullary spinal cord tumors should be promoted.