26例臂丛神经鞘瘤的显微手术治疗

Microsurgical Treatment of 26 Cases of Schwannoma in Brachial Plexus

目的探讨臂丛神经鞘瘤显微手术的治疗要点。方法回顾性总结2000年1月～2009年10月我院收治的26例臂丛神经鞘瘤患者的临床资料,其中臂丛上干11例,中干10例,内侧束2例,外侧束1例,C5-71例,C6-71例,均实行显微镜下手术切除。结果 26例患者臂丛神经鞘瘤均完整切除,术后无臂丛神经受损表现。病理提示Antoni A型18例,Antoni B型8例。随访6个月到10年,无一例复发。结论臂丛神经鞘瘤的显微外科手术治疗应尽量避开神经纤维,保护好神经干,逐层剥离包膜,将瘤体完整切除,多能获得较满意的疗效。

Objective To investigate the key points of the microsurgical treatment of schwannomas in brachial plexus.Methods There were twenty-six cases of schwannoma in brachial plexus verified with pathology and clinical from February 2000 to October 2009.There were 11 located at the superior trunk of brachial plexus,10 at the middle trunk,2 at the medial cord,1 at the lateral cord,1 at the 5th and 6th cervical nerve roots and 1 at the 6th and 7th cervical nerve roots.Microsurgical removal of the tumors was done in all cases. Results 26 cases with schwannoma in brachial plexus were completely resected.The pathological examination showed 18 cases of Antoni A and 8 of Antoni B.There was no function deficit or recurrence over a period of follow-up from 6 months to 10 years.Conclusion Microsurgical treatment of schwannoma in brachial plexus should avoid the nerve fiber injury,protect nerve trunk,detach the envelope of schwannoma by layers and resect the tumor completely.