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椎管内髓外硬膜下肿瘤手术治疗的临床分析 被引量:5

Clinical analysis of intradural extramedullary tumor surgery
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摘要 [目的]探讨椎管内髓外硬膜下肿瘤的手术治疗结果,分析影响髓外硬膜下肿瘤术前症状与预后及复发的因素。[方法]自2004年1月~2009年1月采用外科手术治疗髓外硬膜下肿瘤84例,男41例,女43例。年龄14~76岁,平均44.2岁。病程1周~15年,平均25.3个月。通过视觉模拟评分(VSA)评估疼痛,Nurick′s分级评估神经功能来探讨手术的疗效,同时调查肿瘤病理诊断类型,术前症状持续时间及肿瘤在髓外硬膜下的位置并分析这些因素对术前神经症状和预后的影响。[结果]随访1~5年,平均30个月。在所有病例中VSA评分从8.0±1.2减到1.2±0.8(P<0.005),Nurick’s分级从3.0±1.3减到1.0±0.0(P<0.001),患者的术前症状有明显改善。术前症状与肿瘤类型、症状持续时间和肿瘤位置无明显相关性,术后疗效与术前症状严重性及病程长短有关。5例髓外硬膜下肿瘤复发。[结论]髓外硬膜下肿瘤多可通过后路手术切除,大部分病例症状明显改善。积极手术切除是髓外硬膜下肿瘤治疗的有效途径。 [Objective]To investigate the results of surgical treatment and analyze the factors that affect the neurologic symptoms,prognosis and recurrence of intradural extramedullary tumor.[Method]Eighty-four cases of intradural extramedullary tumor were surgically treated from Jan 2004 to Jan 2009.Forty-one were male and forty-three were female,aged from 14 to 76 years(average,44.2 years).The course of illness was from 1 week to 15 years(mean,25.3 months).Visual analogue scale(VAS) and Nurick's grading were respectively used to evaluate pain and neurological function.Pathological diagnosis type of tumor,preoperative symptom duration and intraspinal tumor location were investigated.The impact of these factors on neurological symptoms and prognosis were analyzed.[Result]The follow-up period ranged from 1 to 5 years(mean,30 months).In all cases,VAS score reduced from 8.0 ± 1.2 to 1.2 ± 0.8(P0.005),and Nurick's grading reduced from 3.0 ± 1.3 to 1.0 ± 0.0(P 0.001),the symptoms were significantly improved.Tumor type,duration of symptoms and tumor location had no significant effect on symptoms.The severity and duration of symptoms were related to postoperative efficacy.Five cases of intradural extramedullary tumor recurred.[Conclusion]All intradural extramedullary tumors can be resected through the posterior approach,in most cases symptoms improved significantly.Therefore,active surgical resection is an effective treatment of intradural extramedullary tumor.
出处 《中国矫形外科杂志》 CAS CSCD 北大核心 2010年第18期1506-1509,共4页 Orthopedic Journal of China
关键词 髓外硬膜下肿瘤 手术治疗 预后 复发 intradural extramedullary tumor surgical treatment prognosis recurrence
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