脊髓胶质母细胞瘤患者的临床特点及显微外科手术疗效  

The clinical characteristics and microsurgery treatment of patients with spinal cord glioblastoma

作　　者：赵树鹏[1] 杨宝[2] 刘海[2] 贾文清[2] 徐宇伦[2] 杨俊[2] 

机构地区：[1]新乡医学院第一附属医院神经外科,河南省卫辉市453100 [2]首都医科大学附属北京天坛医院神经外科

出　　处：《中华医学杂志》2016年第17期1368-1370,共3页National Medical Journal of China

摘　　要：目的探讨脊髓胶质母细胞瘤的临床特点及以显微外科手术治疗为主的疗效。方法对北京天坛医院2011年1月至2014年12月18例脊髓胶质母细胞瘤的病例特点、显微外科手术治疗及术后放化疗的临床资料进行回顾性分析。结果肿瘤近全切除12例，大部分切除4例，活体组织检查2例。术后3个月神经系统症状改善11例，无变化5例，加重2例，无死亡病例。其中术前McCormick I级患者中改善5例（5／5），Ⅱ级中改善4例（4／7），Ⅲ级中改善2例（2／4），1V级0例改善（0／2）。术后3个月McCormick临床分级I级8例，Ⅱ级5例，Ⅲ级2例，Ⅳ级3例。本组病例17例随访，1例失访，随访6～36个月，5例恢复正常工作学习，8例已死亡，中位生存期16个月。结论脊髓胶质母细胞瘤是高度恶性肿瘤，发病率低，预后较差，宜早期手术治疗，术后可辅助放化疗。Objective The aim is to explore the clinical characteristics of spinal cord glioblastoma and the therapeutic effect of microsurgery. Methods The clinical data of 18 patients with spinal cord glioblastoma from January 2011 to December 2014 in Beijing Tiantan Hospital were retrospectively analyzed including the clinical characteristics, the microsurgery treatment and the postoperative radiochemotherapy. Results There were 12 cases for subtotal resection, 4 cases for partial resection and 2 cases for biopsy of the intraspinal tumors under microscope. The nervous system symptoms were improved in 11 cases, no changes in 5, deterioration in 2 and no deaths within 3 months after the operation. Among those, 5 cases （ 100% ） with preoperative McCormick grade I , 4 （57%） with grade II , 2 （50%） with grade 1I, and 0 with grade 1V had improved. There were McCormick grade I 8 cases, grade 11 5 cases, grade m = cases andgrade IV 3 cases within 3 months after the operation. Seventeen patients were followed up from 6 to 36 months, and 1 patients was lost to follow-up. Five patients returned to normal work and study, while 8 died. The median survival time was 16 months. Conclusions Spinal cord glioblastoma is highly malignant with low incidence and poor prognosis, which should be performed by early operative treatment and postoperative adjuvant radiochemotherapy.

关 键 词：脊髓 胶质母细胞瘤 显微外科手术 

分 类 号：R739.4[医药卫生—肿瘤]