141例颈部神经鞘瘤诊治分析

Diagnosis and treatment of cervical Schwannoma

目的 研究颈部神经鞘瘤的诊断、手术入路、并发症及预后,并探讨并发症发生的相关因素及采取的预防措施。方法 回顾性分析郑州大学第一附属医院2018年1月-2021年3月收治的141例经病理确诊的神经鞘瘤患者临床资料。结果 141例患者中术前通过影像学检查,99例明确诊断,与病理诊断符合率为70.21%,27例(19.15%)未明确诊断,15例误诊,误诊率为10.64%。133例手术治疗,37例(27.82%)出现并发症,8例观察随访。结论 神经鞘瘤手术治疗术中、术后并发症发生率较高,术前应完善影像学检查,根据肿瘤位置及大小选择合适的手术入路,在完整切除肿瘤的同时尽量保护神经功能。

OBJECTIVE To study the diagnosis,surgical approach,complications,prognosis and the related factors of complications of cervical Schwannoma.METHODSThe clinical data of 141 patients with pathologically confirmed Schwannoma admitted to our hospital from January 2018 to March 2021 were analyzed.RESULTS Among the 141 patients,through preoperative imaging examinations,99 cases can be clearly diagnosed(consistent rate with pathological diagnosis,70.21%),27 cases are not clearly diagnosed(19.15%),15 cases are misdiagnosed(misdiagnosis rate 10.64%).There were 133 cases underwent surgical treatment,and 8 cases selected for observation and follow-up.Of the 133 patients who received surgical treatment,37 cases(27.82%) had intraoperative and postoperative complications(bleeding,neurological impairment,infection,etc.).CONCLUSION Intraoperative and postoperative complications of cervical Schwannoma are relatively higher,preoperative imaging examination should be perfected and the appropriate surgical approach should be chosen according to the location and the size of the tumor.Nerve function should be protected while removing tumor.