显微手术治疗成人腰骶椎管内脂肪瘤远期随访疗效和危险因素分析  

Long-term follow-up effect and risk factors analysis of microsurgery for treatment of adult patients with spinal cord lipomas

作　　者：周青[1] 汤可[1] 周敬安[1] 

机构地区：[1]解放军第309医院神经外科,北京100091

出　　处：《临床军医杂志》2013年第10期1025-1027,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨成人腰骶椎管内脂肪瘤的病变特点、手术方式与远期治疗效果的关系。方法回顾性分析77例成人腰骶椎管内脂肪瘤患者的临床特点、治疗手段和随访结果。结合性别、年龄、脂肪瘤分型、术前神经功能障碍持续时间、有无腰骶椎管探查手术史、是否部分切除脂肪瘤等因素和随访结果进行统计学分析。结果出院时神经功能障碍改善51例(66.2%),无一例患者症状加重,经统计学分析,腰骶椎管探查手术史与远期神经功能再次恶化显著相关,性别、年龄、脂肪瘤类型、症状持续时间、部分切除与神经功能远期再次恶化相关性不明显。结论显微手术治疗成人腰骶椎管内脂肪瘤安全可靠,手术应尽早实施。腰骶椎管探查手术史与成人合并神经功能障碍患者远期预后关系密切。Objective To discuss the relationship among long-term follow-up therapeutic effect, microsurgery and lesion characte-ristics in adult patients with lumbosacral spinal cord lipomas. Methods We analyzed the baseline information, therapeutic meth-ods and follow-up outcome of 77 adult patients with lumbosaeral spinal cord lipomas. Statistic analysis was employed to evaluate the significance of risk factors involving gender, age, category of lesion, duration of symptom, manipulation history and partial resec-tion. Results Ameliorations of neurological dysfunction were achieved in 51 cases （66.2%）. None of cases deteriorated postop- eratively at discharge. Manipulation history was significantly relative with aggravation of nerve function. Nevertheless, no significant relationship was observed for gender, age,category of lesion, duration of symptom and partial resection. Conclusion Microsurgery is safe and reliable to treat lumbosacral spinal cord lipomas, and it should be performed as soon as possible. Operation history of lumbosacral spinal cord is potential predictor of poor prognostic for adult patients with nerve dysfunction.

关 键 词：椎管内脂肪瘤 显微手术 远期疗效 危险因素 

分 类 号：R738.6[医药卫生—肿瘤]