半椎板入路切除髓外硬膜下肿瘤的疗效分析  

Comparative Study of the Unilateral Hemilaminectomy Approach and the Total Laminectomy Approach in the Treatment of Subdural Extramedullary Tumors

作　　者：李晓东[1] 徐军[2] 

机构地区：[1]宁夏医科大学,银川750004 [2]宁夏医科大学心脑血管病医院神经外科,宁夏颅脑重点实验室

出　　处：《医学研究杂志》2015年第7期110-113,共4页Journal of Medical Research

摘　　要：目的：对髓外硬膜下肿瘤切除术中应用半椎板开窗入路方案的临床表现及医疗价值进行科学评估。方法对2010年9月-2013年9月宁夏医科大学附属医院神经外科100例髓外硬膜下肿瘤病例进行分组，分为观察组和对照组两个实验组，分别采取半椎和全椎板开窗入路方案进行肿瘤全切除手术，并对患者的临床指标，包括术中出血情况、手术用时、术后住院、手术效果以及术后半年到1年的肿瘤复发率等进行比对研究。结果观察组病例的术中出血情况、手术用时及术后住院都显著少于对照组，差异有统计学意义（P＜0．05）。观察组患者和对照组患者在术后疗效方面比较，差异无统计学意义（P＞0．05）。术后脊柱不稳定病例数，观察组0例，明显低于对照组3例的风险水平，差异有统计学意义（ P＜0．05）。结论在充分分析患者病理情况的基础上，在进行椎管内肿瘤切除手术中合理采取半椎板开窗入路方案，具有手术效果好、创伤小、康复快、并发症少等优势特点，对患者的脊柱活动水平和稳定性具有较好的保护效果。Objective To compare the clinical results of the unilateral hemilaminectomy approach and the total laminectomy approach in the treatment of subdural extramedullary tumors.Methods One hundred cases with subdural extramedullary tumors from Sep-tember 2010 to September 2013 in the General Hospital of Ningxia Med.Univ.underwent surgery intervention were prospective analyzed. Among them,50 cases（ the observation group） received tumor resection by the unilateral hemilaminectomy approach,and another 50 cases （ the control group） received the treatment by the total laminectomy approach.All received electrophysiological monitoring in the operation.Operation time,intraoperative bleeding,postoperative hospitalization duration and postoperative recurrence rate in 6 months to 1 year etc.were recorded and compared.Results Operation time,intraoperative bleeding,postoperative hospitalization duration and postoperative fields time in the the observation group were less than the control group（P〈0.05）.There was no significant difference in curative effect aspects.In the postoperative follow-up（6 months to 1 year） ,the spinal instability cases in the observation group（0 case） was significantly less than the control group （6 cases）.Conclusion Compared with the total laminectomy approach,the unilateral hemilaminectomy ap-proach in the treatment of subdural extramedullary tumors has more advantages as follows：better curative effect, smaller trauma, quicker recovery, fewer complications, great maintenance in spinal mobility and stability etc.

关 键 词：半椎板开窗 全椎板开窗 髓外硬膜下肿瘤 

分 类 号：R6[医药卫生—外科学]