脊髓髓内肿瘤的诊断及其外科治疗  

DiagnosisandSurgicalTreatmentofIntramedularySpinalCordTumors

作　　者：李书忠[1] 胡有谷[1] 陈晓亮[1] 赵振玖 郑英刚[1] 陈伯华[1] 

机构地区：[1]青岛医学院附属医院骨科

出　　处：《中华骨科杂志》1996年第5期315-317,共3页Chinese Journal of Orthopaedics

摘　　要：作者报告１７例脊髓髓内肿瘤的诊断及其外科治疗结果。病史２年以内者居多为７０．５％，２０～４０岁占７６．５％，首发症状主要为肢体麻木无力或（及）感觉异常，特有的临床表现和ＭＲＩ或ＣＴＭ检查为主要的临床诊断依据。病理诊断以颈段、颈胸段及上胸段室管膜瘤多见共９例，其次是星形细胞瘤４例。１７例均经后路手术：肿瘤全部切除９例，其中室管膜瘤７例，大部切除减压５例，脊髓背侧切开减压活检３例。随访６个月～４９．３月，平均１１．８个月，神经机能明显改善者８例，脊髓机能评分提高１１～２０分者５例，１０分以下者３例，病情稳定者４例。本文重点讨论其诊断。SeventeencasesofintramedularyspinalcordtumorsunderwentsurgicaltreatmentfromJanuary1990toJanuary1994werereviewed.Therewere7malesand10females,withagebetween14and56yearsandameanof29.3years.Theinitialsymptomswerepredominantlysensoryandmotordeficitsbelowthelevelofthelesions.70.5%ofthepatientshadthehistoryofilnessoflessthantwoyears.TheclinicaldiagnosisdependeduponspecialclinicalsymptomsandsignsaswelasthefindingsofMRIandCTM.Themajorityofthecaseswereependymonmas(9cases)andastrocytomas(4cases).Thelesionswerelocatedoverinthecervical,cervico-thoracicortheupperthoracicregions.Thetumorsweretotalyremovedin9cases,decompressionwasdonein5casesandbiopsyanddecom-pressionin3cases.Thefolow-upperiodextendedfrom6to49.3monthswithanaverageof11.8months.In13ofthe17patientstheneurologicalconditionwassignificantlyimprovedorstabilizedasaresultofthesurgicaltreatment.

关 键 词：脊髓肿瘤 诊断 外科手术 

分 类 号：R739.42[医药卫生—肿瘤]