显微神经外科技术在胸段钙化脊膜瘤手术中的应用  

作　　者：邓勇 陈铮立 叶世泰 张司玺 郗玉珍 苏杰 王树超 

机构地区：[1]解放军联勤保障部队第903医院,浙江杭州310004

出　　处：《浙江临床医学》2024年第10期1484-1486,共3页Zhejiang Clinical Medical Journal

基　　金：杭州市卫生科技基金项目(B20200452)。

摘　　要：目的探讨显微神经外科技术在胸段钙化脊膜瘤手术中的应用。方法回顾性分析25例胸段钙化脊膜瘤患者的临床资料。分析患者年龄、性别、肿瘤所在节段、肿瘤最大横截面、肿瘤是否钙化及钙化程度、手术出血量、手术时间、手术切除程度、有无伴随疾病及住院时间。采用胸段JOA评分(11分法)评估患者术前、出院时及末次随访脊髓神经功能状态;采用Simpson分级评估患者脊膜瘤切除程度。结果25例患者均行显微手术治疗,术中发现肿瘤呈部分钙化19例,骨片状钙化者3例,完全钙化者3例;手术时间(179.12±57.32)min,术中出血量为(504.00±368.32)mL。22例肿瘤全切除(simpsonⅠ级2例,simpsonⅡ级20例),1例次全切除,后复发行手术再切除。术后病理检查结果均为脊膜瘤,均伴有钙化。术后22例患者症状均有不同程度改善;1例恶化,经保守及康复治疗后术前症状消失;1例手术后病情稳定。结论钙化脊膜瘤患者采用显微神经外科术可提高手术疗效,减少术后神经功能障碍发生率。Objective To explore the application of microsurgery in thoracic calcified meningioma.Methods Retrospectively analysed the clinical data of 25 patients with thoracic calcified meningioma.Compare the age,gender,tumor segment,maximum cross-sectional area of the tumor,whether the tumor is calcified and the degree of calcification,surgical bleeding volume,surgical time,degree of surgical resection,presence of accompanying diseases,and length of hospital stay of the selected patients.The thoracic(Japanese Orthopaedic Association)JOA score(11 points)was used to evaluate the spinal cord nerve function status of patients before surgery,at discharge,and at the last follow-up.Simpson grading was used to evaluate the degree of resection of spinal cord tumors in patients.Results All 25 patients underwent microsurgical treatment.During the operation,19 cases were found to have partial calcification of the tumor,3 cases had bone like calcification,and 3 cases had complete calcification.The operation time was(179.12±57.32)minutes,and the intraoperative blood loss was(504.00±368.32)mL.22 cases of tumors were completely resected(2 cases were Simpson grade I,and the rest were Simpson grade II),1 case underwent subtotal resection,and then underwent repeat surgery for resection.The postoperative pathological results were all meningiomas,accompanied by calcification.All 22 patients showed varying degrees of improvement in their symptoms after surgery.One case worsened,and preoperative symptoms disappeared after conservative and rehabilitation treatment.One patient's condition remained stable after surgery.Conclusion Microsurgery can improve surgical efficacy and reduce the incidence of postoperative neurological dysfunction in patients with calcified meningioma.

关 键 词：胸段脊膜瘤 钙化 显微手术 

分 类 号：R739.42[医药卫生—肿瘤]