显微外科治疗高颈段椎管内肿瘤疗效观察  

Experience of Microsurgery Treatment of High Cervical Intraspinal Tumors Under Neuroelectrophysiological Monitoring

作　　者：程高鹏[1] CHENG Gaopeng(Department of Neurosurgery,Peace Hospital Affiliated to Changzhi Medical College)

机构地区：[1]长治医学院附属和平医院神经外科,046000

出　　处：《长治医学院学报》2021年第3期196-199,共4页Journal of Changzhi Medical College

摘　　要：目的:探讨高颈段椎管内肿瘤的显微外科治疗术中神经电生理监测技术的应用及手术效果。方法:回顾性分析52例高颈段椎管内肿瘤患者的临床资料。所有患者均经术前MRI确诊,并在神经电生理监测下实施显微外科手术治疗,术后行MRI复查。结果:(1)本组52例中48例(92.30%)采用颈后正中入路,2例颈外侧入路(3.85%),2例颈前及颈后联合入路(3.85%)。肿瘤全切47例(90.39%),次全切除4例(7.69%),部分切除1例(1.92%)。(2)术后病理检查52例中室管膜瘤7例,星形细胞瘤3例,血管母细胞瘤、海绵状血管瘤各1例,神经鞘瘤34例,脊膜瘤4例,节细胞神经瘤2例。(3)术后随访34例,随访时间0.5~4年,术后神经功能评价JOA评分高于术前[(16.31±1.22)vs(10.21±1.72)分],差异有统计学意义(P<0.05)。结论:在神经电生理监测下运用显微外科技术治疗高颈段椎管内肿瘤手术效果良好。Objective:To explore the application of intraoperative neurophysiological monitoring and the effect of surgery for microsurgical treatment of tumors in the high cervical spinal canal.Methods:The clinical data and follow-up data of fifty-five cases diagnosed tumors of high inner cervical tube were retrospectively analyzed.All the patients were taken MRI scanning pre-operation,monitored in the operation under neurophysiological monitoring,and reexamined by MRI scanning post-operation.Results:48 of 52 cases(92.30%)were taken suboccipital posterior approach,two cases(3.85%)were chosen lateral cervical approach,and two cases(3.85%)were chosen combined anterior and posterior approach.The number of total tumor resection was 47 cases(90.39%),subtotal resection was 4 cases(7.69%),and partial resection was 1 case(1.92%).The results of pathology showed ependymoma(7 cases),astrocytoma(3 cases),hemangioblastoma(1 case),cavernous hemangioma(1 case),Neurilemmoma(34 cases),meningioma(4 cases),ganglioneuroma(2 cases).In follow-up 34 cases(average 0.5~4 years),JOA score of post-operation was higher than pre-operation(P<0.05).Conclusion:The use of microsurgery techniques to treat high cervical intraspinal tumors under neuro-electrophysiological monitoring has good results.

关 键 词：高颈段椎管内肿瘤 显微外科手术 神经电生理监测 

分 类 号：R739.4[医药卫生—肿瘤]