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目的总结椎管内肿瘤的诊断治疗经验。方法对神经外科自2003年11月-2012年9月以来治疗的40例原发性椎管内肿瘤患者临床资料进行回顾性分析。结果 40例患者均行手术治疗,肿瘤均完整切除,术后均经病理证实椎管内良性肿瘤,患者术后临床症状及神经功能均有明显恢复。术前28例出现运动障碍的病例,术后症状均有明显改善。20例感觉障碍病例,术后明显改善16例,4例无明显变化。4例括约肌功能障碍病例,3例明显改善,1例无变化。术前27例疼痛患者,术后明显改善26例。1例患者出现脑脊液漏并发症,经对症治疗好转。本组未出现术后症状较术前加重者,无死亡病例。结论椎管内肿瘤的早期诊断极为重要,MRI检查是最有价值的影像学诊断。患者术后生存质量,常与患者术前的脊髓神经功能损伤程度直接相关。原发性椎管内肿瘤以良性居多,做到早期发现椎管内肿瘤,早期手术治疗,多能取得良好的治疗效果。
Objective To summarize the experience of diagnosis and treatment of spinal canal tumor. Methods The clinical data of 40 patients with primary spinal tumors treated in neurosurgery since November 2003 to September 2012 were analyzed retrospectively. Results All the 40 patients underwent surgical treatment. The tumors were completely resected. All the benign tumors in the spinal canal were confirmed by pathology. The clinical symptoms and neurological function of the patients were obviously recovered. Preoperative 28 cases of dyskinesia, postoperative symptoms were significantly improved. Twenty cases of sensory disturbances were significantly improved in 16 cases and no significant changes in 4 cases. 4 cases of sphincter dysfunction, 3 cases improved significantly, 1 case no change. Twenty-seven patients had pain before operation, and 26 patients improved significantly after operation. A case of cerebrospinal fluid leakage complications, the symptomatic treatment improved. This group did not appear postoperative symptoms worse than preoperative, no deaths. Conclusion Early diagnosis of spinal canal tumor is extremely important. MRI is the most valuable imaging diagnosis. The postoperative quality of life of patients is often directly related to the extent of preoperative spinal cord injury. Primary spinal canal tumors with benign, early detection of spinal tumors, early surgical treatment, and more able to obtain good therapeutic effect.