22例臂丛神经鞘瘤的临床诊断及显微外科治疗  

Clinical diagnosis and microsurgery treatment of schwannoma in brachial plexus

作　　者：张祥翊[1] 王拥军[1] 张建[1] 周喆刚[1] 肖颖锋[1] 李进淼[1] 万圣祥[1] 

机构地区：[1]北京大学深圳医院显微手外科,深圳518036

出　　处：《重庆医学》2009年第21期2705-2706,共2页Chongqing medicine

摘　　要：目的探讨臂丛神经鞘瘤的临床诊断方法，总结显微外科治疗体会。方法回顾性分析1998～2008年22例经显微外科手术及病理确诊为臂丛神经鞘瘤的患者病历资料，归纳总结其诊断特点和显微手术体会。结果22倒患者源自臂丛C5、6神经根2例，C7神经根1例，上干4例，中干6例，下干2例，外侧束3例，后侧柬2例，内侧束2例。其中18例获得随访，术后平均随访18个月（6个月至7年），2例因其他科室误诊为颈部淋巴结术后出现神经症状外，其余病例均接受显微手术治疗，术后无复发，臂丛神经功能正常。2例误诊患者行Ⅱ期神经修复后，均有不同程度的功能恢复。结论臂丛神经鞘瘤的有效诊治依赖于对该疾病的全面认识、术前影像学检查、术中神经刺激仪的精确定位，以及高倍显微镜下的显微外科无损伤操作。Objective To investigate the clinical diagnosis of schwannoma in the brachial plexus and to summarize experiences of microsurgery. Methods Twenty-two cases with schwannoma of brachial plexus were reviewed from 1998. All of the cases were diagnosed as schwannoma of brachial plexus microsurgically and pathologically. To induce the characteristics of diagnosis and experiences of microsurgery. Results There were 2 in the 5th and 6th cervical nerve root, 1 in the 7th cervical nerve root,4 in the superior trunk of brachial plexus,6 in the middle trunk,2 in the inferior trunk,3 in the lateral cord,2 in the medial cord and 2 in the posteri- or cord. A 6-month to 7-year follow-up study in 18 out of 22 cases showed that 20 patients had normal function postoperatively without recurrence. The other 2 cases resected mistakenly as lymph node of neck had variable functional restoration after the neural prosthesis. Conclusion The effective diagnosis and treatment of schwannoma of brachial plexus depend on allround knowledges, preoperative imaging check, the application of neurostimulation equipment, high power microscope using and microsurgical tech- nique.

关 键 词：臂丛 神经鞘瘤 周围神经 诊断 显微外科手术 

分 类 号：R739.43[医药卫生—肿瘤]