椎管内肿瘤的诊断治疗  

The Diagnosis and Treatment of Intraspinal Tumor

作　　者：贺宝荣[1] 郝定均[1] 吴起宁[1] 宋宗让[1] 陈海波[1] 

机构地区：[1]西安市红十字会医院脊柱外科一病区,710054

出　　处：《美中国际创伤杂志》2011年第3期46-48,共3页U.S.Chinese International Journal of Traumatology

摘　　要：目的：总结椎管内肿瘤的诊断治疗经验。方法：回顾性分析1992～2003年123例椎管内肿瘤的治疗结果。结果：脊膜瘤24例（19．5％），神经鞘瘤／神经纤维瘤32例（26．0％），室管膜瘤8例（6．5％），星形细胞瘤13例（10．6％），脂肪瘤10例（8．1％），转移瘤5例（4．1％），血管瘤5例（4．1％），蛛网膜囊肿9例（7．3％），其它17例（13．8％）。其中髓外硬膜内57．7％，硬膜外21．1％，髓内22．8％。颈段30．1％，胸段37．4％，腰段19．5％，骶段13．0％。髓外肿瘤70．1％，髓内肿瘤60．7％，全切除率69．1％。运动改善率75．2％。感觉障碍改善73．8％，括约肌功能改善77．8％。结论：椎管内肿瘤以良性居多，手术效果好，MRI检查和显微外科技术的应用是提高治疗效果的关键。如果术中破坏了脊柱的稳定性，重建稳定性非常必要。Objective： To summarize the clinical experiences of diagnosis and treatment of intraspinal tumor. Methods： From 1992 to 2003, the therapeutic results of 123 patients with intraspinal tumor were retrospectively analyzed. Results： The intraspinal tumors in those patients included meningiomas／neurofibroma in 32 cases （19.5%）, neurinoma in 32 cases （26.0%）, ependymoma in 8 cases （6.5%）, astrocytoma in 13 cases （10.6%）, lipoma in 10 cases （8.1%）, metastatic tumors and hemangioma in 5 cases （4.1%） respectively, arachnoid cyst in 9 eases （7.3%）, other tumors in 17 eases （13.8%）. Among them, included extramedullary subdural tumors （57.7%）, epidural tumors （21.1%） and intramedullary tumors （22.8%）. According to the loca- tion, 30.1% tumors located at cervical region, 37.4% at thoracic region, 19.5% at lumbar region and 13.0% at sacral segments. The total removal rate of tumors was 69.1% （total removal rate of extramedullary tumors was 70.1% and intramedullary tumors was 60.7%）. improvement rate of movement, sensation and sphincter function was 75.2%, 73.8% and 77.8%. Conclusion： The surgical outcome is satisfied because most of the intraspinal tumors are benign. The Key to improve the treatment effect is MRI and mierosurgical techniques application. The spinal stability reconstruction is in the extreme need if spinal stability is damaged during the operation.

关 键 词：椎管内肿瘤 诊断 外科治疗 显微外科 

分 类 号：R473[医药卫生—护理学]