小儿原发性椎管内肿瘤(附77例分析)

An Analysis of Primary Intraspinal Cannal Tumor in Children

目的 :作者通过对 77例小儿原发性椎管内肿瘤进行综合分析 ,旨在为临床医生提供详尽材料 ,以关注此病的诊断与治疗。方法 :对 77例原发性椎管内肿瘤的病理分型、发病率、发病部位进行了回顾性分析 ,特别是对MRI的影像特点进行了重点论述。结果 :77例均行手术治疗。肿瘤全切 76例 ,仅 1例室管膜瘤行部分切除治疗。全部病例获得随访。术后症状消失或明显改善 76例。脂肪瘤及脂肪纤维瘤占 48% ,皮样囊肿及畸胎瘤占 2 2 % ,蛛网膜囊肿占 15 .6% ,神经纤维瘤占 4%。 80 %的病人肿瘤发生在腰骶部 ,所以常常合并脊髓栓系综合征。结论 :①小儿原发性椎管内肿瘤以先天性的肿瘤为常见 ,而成人常见的神经鞘膜瘤和神经胶质瘤不多见。②MRI是椎管内肿瘤目前最精确的诊断方法 ,对肿瘤的治疗和预后价值极大 ,应广为利用。③一旦确诊应尽早手术治疗。

Objective: Pediatric primary intraspinal cannal tumor is rarely found. Because of the non symptomatic early stage of the tumor, usually, it is difficult to get an earlier diagnosis. 77 patients with this disease are studied here with the hope to give some help to the clinical workers. Method: From 1988 to 2000 June, 77 patients with pediatric primary intraspinal cannal tumor were analyzed respectively. The pathologic types, attack rate, location of the lesion and the magnetic resonance imaging(MRI) of this disease were separately discussed. MRI as an important diagnostic method is especially emphasized here. Result: Lipoma and lipofibroma was 48%, Dermoid cyst and teratoma was 22%, Arachonoid cyst 15.6% , Neurofibroma 4%. Conclusion: ①The most frequent occurence of pediatric primary intraspinal cannal tumors are congenital disease, such as neurinoma and glioma which are easily seen in adults and rare in children. ②MRI is the most accurate diagnostic method of this disease today. ③Surgery treatment should be given to the patient as soon as the diagnosis is made.