脊髓结核瘤20例临床分析  

Clinical analysis of 20 patients with intramedullary tuberculoma

作　　者：邓兵[1] 黄思庆 徐学君[1] 辛泉[1] 郑毅[1] 

机构地区：[1]成都市第二人民医院神经外科,四川成都610017 [2]四川大学华西医院神经外科,四川成都610041

出　　处：《实用医院临床杂志》2016年第6期76-78,共3页Practical Journal of Clinical Medicine

摘　　要：目的：总结脊髓结核瘤病例临床与随访资料，探讨其诊断及治疗策略。方法回顾性分析2005～2015年我科收治的20例脊髓结核瘤的临床资料和不同治疗方式的疗效。3例脊髓结核瘤合并脑结核瘤经立体定向活检确诊；仅有脊髓结核瘤者17例。所有脊髓结核瘤均行脊髓减压术，所有患者均接受18月的正规抗结核治疗。结果本组3例同时合并脑结核瘤者，2例症状改善明显，1例无改善。17例直接行脊髓减压术者中，15例术后症状有不同程度的改善，2例症状相对稳定。结论髓内结核瘤推荐行外科手术减压。提倡早期、足量、足疗程的正规四联抗结核药物治疗。Objective To summarize the clinical and follow-up data of intramedullary tuberculoma and search the diagnostic and treatment strategies.Methods The clinical data and the efficacy of different treatment modalities of 20 patients with intramedullary tuberculoma during the past 10 years were retrospectively analyzed.Of the patients,3 cases were combination of cerebral tuberculoma that was diagnosed through stereotactic biopsy,and another 17 were intramedullary tuberculoma only.All the intramedullary tuberculoma underwent spinal cord decompression surgery and received 18 months of regular anti-TB treatment.Results Of the 3 cases with combi-nation of tuberculoma,symptoms in 2 cases were improved markedly,and one case had no improvement.In the 17 cases who underwent the direct line of spinal cord decompression,15 patients with postoperative symptoms were improved at varying degrees,and two cases of symptoms were relatively stable.Conclusion Earlier surgical decompression is recommended for intramedullary tuberculoma.The reg-ular quad anti-TB drug treatment at early stage with enough dosage and sufficient course is advocated.

关 键 词：结核瘤 立体定向活检 脊髓减压术 抗结核治疗 

分 类 号：R739.42[医药卫生—肿瘤]