累及高颈段的脊髓肿瘤显微手术治疗  

Microsurgical management of spinal cord tumor involving high cervical cord

作　　者：韩硕[1] 张晓华[1] 殷玉华[1] 韩东华[2] 任力[2] 

机构地区：[1]上海交通大学医学院附属仁济医院神经外科,上海200127 [2]复旦大学附属浦东医院神经外科

出　　处：《临床神经外科杂志》2017年第4期258-262,共5页Journal of Clinical Neurosurgery

基　　金：浦东新区卫生系统重点专科建设项目(PWZz 2013-18);上海市浦东医院院级课题(201403)

摘　　要：目的探讨累及高颈段脊髓肿瘤的临床特点、手术方法及相关预后。方法回顾2007年1月~2017年4月经手术治疗的18例累及高颈髓的脊髓肿瘤患者,并结合有关文献进行相关分析。结果 18例患者中全切除12例,部分切除3例,减压并取活检3例。术后随访,1例神经鞘瘤3年后复发,再次手术。术后16例上下肢肌力4~5级,2例四肢肌力2~3级,1例因呼吸衰竭死亡。McCormick标准分级和颈椎日本骨科协会(JOA)评分均改善(P<0.05~0.001)。结论显微手术为累及高颈段的脊髓肿瘤患者带来明确手术获益,但需避免出现术后并发症。Objective To evaluate the diagnosis,management and outcome of spinal cord tumor involving high cervical cord. Methods The date of 18 patients with spinal cord tumor involving high cervical cord whom treated microsurgically in our institution were analyzed retrospectively,in combination with related literature. Results Total resection were achieved in 12 patients,partial resection in 3 patients and decompression with biopsy in 3 patients. After 3 years time of follow-up,a patient diagnosed of schwannoma recurred and reoperated. Muscle strength of 16 patients were grade 4 ~ 5 of 5,and 2 patients were grade 2 ~ 3 of 5. Death of 1 patient was caused by respiratory failure. The scores of cervical vertebra Japanese Orthopaedic Association（ JOA） were improved obviously（ P 〈0. 05 ~ 0. 001）. Conclusion The microsurgical operation can bring benefit for patients of spinal cord tumor involving high cervical spinal cord,but we should be aware of postoperative complications.

关 键 词：显微手术 高颈髓 脊髓肿瘤 

分 类 号：R739.4[医药卫生—肿瘤]