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目的:探讨脊髓髓内肿瘤的治疗方法。方法:回顾性分析1993年1月-2 0 0 2年2月,我科收治的166例脊髓髓内肿瘤患者的病史资料,总结分析患者术前脊髓功能、肿瘤类型、手术方法、近期疗效、随访结果等情况。结果:本组室管膜瘤87例,星形细胞瘤41例,血管母细胞瘤16例,海绵状血管瘤8例,脂肪瘤6例,其他少见肿瘤8例;术前以中度脊髓功能障碍者居多。165例(99.9% )患者采用后正中入路,1例采用经肋骨横突入路。肿瘤全切除13 7例(82 .5 % ) ,次全切除2 0例(12 .1% ) ,部分切除9例(5 .4% )。出院时症状体征改善者84例(5 0 .6% ) ,稳定者5 1例(3 0 .7% ) ,加重者2 8例(16.9% ) ,死亡3例(1.8% )。获随访者62例,随访期平均5 .2 9年,随访结果死亡6例(9.7% ) ,存活5 6例(90 .3 % ) ,其中9例(16.1% )恢复工作能力,2 4例(4 2 .9% )生活能自理,15例(2 6.8% )生活能部分自理,8例(14 .2 % )生活完全不能自理。结论:对髓内肿瘤宜采取积极手术治疗的态度,根据不同病理类型、不同部位采用不同治疗策略,应用适当手术入路与手术技巧可获得良好效果。
Objective: To explore the treatment of spinal intramedullary tumors. Methods: The clinical data of 166 patients with intramedullary spinal cord tumors treated in our department from January 1993 to February 2002 were retrospectively analyzed. The preoperative spinal cord function, tumor type, operation method, short-term curative effect, Follow-up results and so on. Results: 87 cases of ependymoma, 41 cases of astrocytoma, 16 cases of hemangioblastoma, 8 cases of cavernous hemangioma, 6 cases of lipoma, 8 cases of other rare tumors; preoperative moderate spinal cord function Most people with disabilities. 165 patients (99.9%) were treated with the posterior median approach, and one with transverse approach through the ribs. Totally 13 7 (82.5%) tumors were resected, 20 (12.1%) subtotal resections and 9 (5 .4%) resections. There were 84 patients (56.6%) with symptom and symptom improvement at discharge, 51 stable patients (30.7%), 28 severe cases (16.9%) and 3 deaths (1.8%). Sixty-two follow-up cases were followed up, with a mean follow-up of 5.92 years. The follow-up results were 6 deaths (9.7%) and 56 (90.3%) survivals, of which 9 (16.1% (42.9%) were able to take care of themselves, and 15 (2 6.8%) were able to take care of themselves partially while 8 (14.2%) were completely unable to take care of themselves. CONCLUSIONS: Intramedullary tumors should adopt a positive surgical treatment attitude. Depending on the type of pathology, different treatment strategies may be used for different sites, and appropriate surgical approaches and surgical techniques may achieve good results.