脊髓髓内胶质瘤的显微外科手术治疗(附42例临床分析)  

Microsurgical treatment of intramedullary spinal cord gliomas: an analysis of 42 cases

作　　者：卢亦成[1] 丁学华[1] 胡国汉[1] 于明琨[1] 骆纯[1] 姜正武[1] 张光霁[1] 

机构地区：[1]第二军医大学长征医院神经外科,上海市神经外科研究所上海200003

出　　处：《第二军医大学学报》2001年第8期711-713,共3页Academic Journal of Second Military Medical University

基　　金：上海市优秀学科带头人基金资助项目(99XD14002)

摘　　要：目的 :分析和评价脊髓髓内胶质瘤显微外科手术的疗效和预后。方法 :回顾性分析显微外科手术治疗脊髓髓内胶质瘤 4 2例的结果。结果 :2 2例室管膜瘤中全切除 1 9例 ( 86.4 % ) ,2 0例星形细胞瘤全切除 9例 ( 45.0 % ) ,全组无手术死亡。3 2例随访 3个月至 5.5年 (平均 3 1个月 )。最近一次随访结束时 (失访者按出院前的神经功能评定 ) :肌力改善 1 5例 ( 3 5.7% ) ,不变2 1例 ( 50 .0 % ) ,加重 5例 ( 1 1 .9% )。结论 :室管膜瘤应力争一期全切除 ,星形细胞瘤不应强调全切除而以手术减压为主。显微神经外科技术可改善脊髓髓内肿瘤的预后。Objective: : To evaluate the results of microsurgi ca l management for intramedullary spinal cord gliomas. Methods: Fo rty two patients received microsurgical resection for intramedullary spinal cor d glioma were studied retrospectively. Results: Of 22 cases with intramedullary ependymoma, complete removal was achieved in 19 patients. Of 20 cases with intramedullary astrocytoma, complete removal was achieved in 9 patien ts. There were no deaths due to surgery. Thirty two patients were followed up for 3 months to 66 months with an average of 31 months. When comparing the preop erative and follow up functional grades, 50.0% remained the same, 35.7% improve d, and 11.9% deteriorated. Conclusion: Intramedullary ependymoma s should be totally resected, while a constrainedly complete resection is not ne cessary for an intraspinal astrocytoma.

关 键 词：脊髓肿瘤 神经胶质瘤 显微外科手术 

分 类 号：R739.42[医药卫生—肿瘤] R730.56[医药卫生—临床医学]