显微手术治疗脊髓室管膜瘤的临床效果及其预后影响因素分析  

The Clinical Effect of Microsurgery in the Treatment of Spinal Cord Ependymoma and Its Prognostic Factors

作　　者：范雁东[1] 孙宏杰 马木提江·木尔提扎 罗坤[1] FAN Yandong;SUN Hongjie;Mamutijiang·Muertizha;LUO Kun(The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;不详)

机构地区：[1]新疆医科大学第一附属医院,新疆乌鲁木齐830054

出　　处：《中外医学研究》2022年第17期45-48,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：新疆维吾尔自治区自然科学基金项目(2019D01C323)。

摘　　要：目的:研究显微手术治疗脊髓室管膜瘤患者的临床效果,分析其预后影响因素。方法:回顾性分析2015年1月-2021年1月在新疆医科大学第一附属医院接受显微手术治疗的100例脊髓室管膜瘤患者的临床资料,使用欧洲脊髓病评分系统(EMS)、MeCormick分级标准对患者手术前后脊髓功能进行评价。根据患者末次随访结果分组(有效组61例、无效组39例),对其预后影响因素进行单因素与Logistic多因素回归分析。结果:本组中接受肿瘤全切除术治疗者64例,肿瘤次全切除术治疗者31例,肿瘤大部分切除术治疗者5例。患者末次随访EMS评分高于术前及术后14 d,差异有统计学意义(P<0.05)。患者术后McCormick分级比例优于术前,差异有统计学意义(P<0.05);Logistic多因素回归分析结果显示,术前伴有大小便功能障碍是显微手术治疗脊髓室管膜瘤患者预后有效的独立危险因素(P<0.05),脊髓空洞是显微手术治疗脊髓室管膜瘤患者预后有效的保护因素(P<0.05)。结论:显微手术治疗脊髓室管膜瘤患者具有良好的长期效果,术前伴有大小便功能障碍是影响患者预后效果的独立危险因素,术前伴有脊髓空洞有利于患者预后。Objective:To study the clinical effect of microsurgery in the treatment of spinal ependymoma and analyze its prognostic factors.Method:The clinical data of 100 patients with spinal ependymoma treated by microsurgery in the First Affiliated Hospital of Xinjiang Medical University from January 2015 to January 2021 were analyzed retrospectively.The spinal cord function of the patients before and after operation was evaluated by European myelopathy scoring system(EMS)and MeCormick grading standard.According to the results of the last follow-up(61 cases in the effective group and 39 cases in the ineffective group),the prognostic factors were analyzed by univariate and Logistic multivariate regression.Result:In this group,64 patients received total tumor resection,31 patients received subtotal tumor resection and 5 patients received partial tumor resection.The EMS scores of patients in the last follow-up was higher than those before operation and 14 days after operation(P<0.05).The proportion of patients with McCormick grading after surgery was better than that before surgery,and the difference was statistically significant(P<0.05).Logistic multivariate regression analysis showed that preoperative urinary and bowel dysfunction was an independent risk factor for the prognosis of patients with spinal cord ependymoma treated by microsurgery(P<0.05).Preoperative syringomyelia was effective protective factors for the prognosis of tumor patients(P<0.05).Conclusion:Microsurgery has a good long-term effect in the treatment of spinal ependymoma.Preoperative defecation dysfunction is an independent risk factor affecting the prognosis of patients.Preoperative syringomyelia is conducive to the prognosis of patients.

关 键 词：脊髓室管膜瘤 显微手术 治疗效果 预后影响因素 

分 类 号：R739.4[医药卫生—肿瘤]