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目的研究应用接触式激光显微手术治疗髓内肿瘤的疗效。方法对我院1998年3月-2003年4月期间入院所有脊髓髓内肿瘤患者随机分为A组和B组。其中A组接受常规显微手术,B组接受接触式激光器配合显微手术。制定严格的纳入和排除标准。术后采用美国脊髓损伤协会ASIA评分标准评分,评分时间分别为术后3个月、6个月、12个月。采用SPSS统计软件统计分析。结果A组30例,肿瘤全切11例(36.67%);近全切除14例(46.67%),大部切除5例(16.67%)。B组25例,肿瘤全切16例(64.00%);近全切除8例(32.00%)。大部切除1例(4.00%)。对两组治疗前后ASIA评分进行统计分析,术后3个月与术前评分差异有统计学意义(P<0.001)。结论⑴接触式激光可以精确地切除和汽化髓内肿瘤,减少副损伤。⑵接触式激光器配合显微手术与单纯使用显微手术相比增加了脊髓髓内肿瘤的切除率和术后功能好转率。⑶术后6个月内脊髓功能恢复良好,6个月后病情趋于稳定。
Objective To study the application of contact laser microsurgical treatment of intramedullary tumors. Methods All patients with intramedullary spinal cord in our hospital from March 1998 to April 2003 were randomly divided into A group and B group. Group A received routine microsurgery and Group B received contact laser with microsurgery. Develop strict inclusion and exclusion criteria. The ASIA score of the American Society of Spinal Cord Injury was used to score the postoperative scores for 3 months, 6 months and 12 months respectively. Using SPSS statistical software statistical analysis. Results A group of 30 patients, 11 cases of tumor resection (36.67%); nearly total resection in 14 cases (46.67%), most of the resection in 5 cases (16.67%). In group B, 25 cases were completely resected and 16 cases were completely resected (64.00%). Eight cases were completely resected (32.00%). Most resection in 1 case (4.00%). The ASIA scores of two groups before and after treatment were statistically analyzed. There was a significant difference between preoperative and postoperative ASIA scores (P <0.001). Conclusion ⑴ contact laser can accurately remove and vaporization of intramedullary tumors, reduce secondary injury. ⑵ contact laser with microsurgery and simple microsurgical surgery increased intramedullary spinal cord resection rate and postoperative functional turnover rate. ⑶ spinal cord function recovered within 6 months after surgery, the disease tended to be stable after 6 months.