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目的分析不同年龄组多节段髓内肿瘤的性质、部位、肿瘤切除程度和患者预后等特点。方法前瞻性分析2002年1月至2009年12月我院收治的78例多节段(≥3个椎体节段)髓内肿瘤患者的资料,以18周岁为界分为未成年组和成年组。77例患者行后正中入路显微镜下肿瘤切除术,术中测量肿瘤的实际长度,HE和免疫组化染色确定肿瘤性质和分级,以IJOA评分评估患者神经功能状况,IJOA分值差(术后IJOA-术前IJOA)判定患者近期预后。采用SPSS17.0统计软件对资料进行统计学分析。结果两组患者的平均住院天数、手术前后IJOA评分、肌力、二便状况以及肿瘤部位、节段数、长径、切除程度等无显著性差异。肿瘤性质:未成年组以偏良性胶质瘤(6例,40%)和先天性肿瘤(6例,40%)多见;成年组以室管膜瘤(29例,46%)多见,有显著性差异(Z=-2.13,P=0.03)。未成年组患者近期预后相对较好,与成年组比较有显著性差异(Z=-2.06,P=0.04)。结论多节段髓内肿瘤在未成年患者中以偏良性胶质瘤(星形细胞瘤Ⅰ-Ⅱ级)和先天性肿瘤多见,成年患者中以室管膜瘤居多;未成年组患者近期预后相对较好。
Objective To analyze the characteristics, location, resection degree and prognosis of multi-segment intramedullary tumors in different age groups. Methods The data of 78 patients with intramedullary multi-segment (≥3 vertebral segments) intramedullary tumors treated in our hospital from January 2002 to December 2009 were prospectively analyzed. The patients were divided into juvenile group and adult group. Twenty-seven patients underwent posterior approach underwent microsurgical tumor resection. The actual length of the tumor was measured during surgery. HE and immunohistochemical staining were used to determine the nature and grade of the tumor. The IJOA score was used to evaluate the neurological status and IJOA score difference IJOA-preoperative IJOA) to determine the patient’s immediate prognosis. SPSS17.0 statistical software was used to analyze the data. Results The average duration of hospital stay, IJOA score, muscle strength, second defecation status, tumor location, number of segments, major axis and extent of resection were not significantly different between the two groups. The nature of the tumor: juvenile group of benign glioma (6 cases, 40%) and congenital tumors (6 cases, 40%) more common; adult group with ependymoma (29 cases, 46% There was a significant difference (Z = -2.13, P = 0.03). The prognosis of the minor group is relatively good, with significant difference compared with the adult group (Z = -2.06, P = 0.04). Conclusions Multi-segment intramedullary tumors are more common in juvenile patients with benign gliomas (grade Ⅰ-Ⅱ astrocytomas) and congenital tumors, with majority of ependymoma in adult patients. In juvenile patients, The prognosis is relatively good.