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目的:回顾分析硬脊膜内外多发性的神经鞘膜瘤的手术治疗疗效及注意事项。方法:我院2001-2011年间脊柱病区收治的椎管内肿瘤患者中,共发现7例硬脊膜内外多发性的神经鞘膜瘤。肿瘤发生部位:胸段3例,腰段2例,2例为胸段肿瘤位于硬膜内,腰段肿瘤位于硬膜外呈哑铃型向椎管外生长。临床表现为隐袭性、进行性双下肢麻木、无力、僵硬和不灵活,行走不稳等症状。治疗方法:全部手术肿瘤摘除,5例一期行硬膜内外同时摘除肿瘤,2例不同节段的肿瘤采取分期手术。结果:全部病例经1-9年随访,肿瘤未见复发。病理报告:均为神经鞘膜瘤。结论:临床上硬脊膜内外多发性的神经鞘膜瘤较少见,容易漏诊漏治。术前应注意详细查体,仔细阅片,术中注意切除硬膜外的肿瘤后,观察硬膜有无异常表现,手术是治疗该病的有效方法。
Objective: To retrospectively analyze the effect and precautions of surgical treatment of multiple neurinoid tumor inside and outside the spinal cord. Methods: In our hospital from 2001 to 2011 in spinal patients admitted to spinal canal tumors, were found in 7 cases of spinal epidural multiple neurogenic sheath tumor. Tumor site: thoracic in 3 cases, lumbar in 2 cases, 2 cases of thoracic tumors located in the dura mater, lumbar tumors located in the dumbbell-shaped dura mater to the outside of the growth. Clinical manifestations of insidious, progressive numbness, weakness, stiffness and inflexibility, walking and other symptoms. Treatment: All surgical tumor removal, 5 cases of a dura at the same time inside and outside the removal of the tumor, 2 cases of different segments of the tumor to take staging. Results: All patients were followed up for 1 to 9 years, no recurrence of tumor. Pathology report: all nerve sheath tumor. Conclusion: The clinical multiple epidural neurinoid epidural tumor is rare, easily missed diagnosis and treatment. Preoperative should pay attention to a detailed examination of the body, carefully read the film, intraoperative attention to removal of epidural tumors, observe the presence of abnormal performance of the dura mater, surgery is an effective method of treatment of the disease.