摘要
目的探讨脊髓髓内室管膜瘤的治疗策略。方法对210例髓内室管膜瘤病人的神经功能状况、肿瘤切除程度、术后并发症与疗效等进行回顾性分析。均行肿瘤显微切除术,椎板复位135例。结果肿瘤全切除195例,次全及大部切除15例。术后行气管切开8例,均为延髓及高颈髓部位的巨大肿瘤病人。术后门诊复查及电话随访130例,随访时间3个月~9年;神经功能改善95例（73%）,明显加重21例（16%）,无变化14例（11%）;术后复发5例,其中肿瘤位于圆锥部分3例,胸髓1例,延颈髓1例。结论大多数髓内室管膜瘤通过早期诊断与及时手术,可获得肿瘤全切除,预后良好。对于严重黏连的肿瘤不应勉强追求全切除。术前功能分级差者,术后神经功能障碍易加重。
Objective To investigate the clinical treatment strategies of intramedullary spinal ependymoma. Methods Clinical data of 210 patients with intramedullary spinal ependymoma were analyzed retrospectively, including pre- and postoperative neurological status, extent of tumor resection, postoperative complications and efficacy, et al. All tumors underwent microsurgical resection, and 135 patients received lamina reduction. Results Total tumor resection was achieved in 195 cases, and subtotal or partial removal in 15. Eight patients with oblongata or upper cervical cord giant tumors received tracheotomy postoperatively. A follow up of 3 months to 9 year by out-patient review and telephone interview were performed in 130 cases： neurological function was improved in 95 cases （73%） , aggravated significantly in 21 （16%）, no changes occurred in 14 （11%）. Tumor recurrence occurred in 5 patients, 3 out of them located in the conus portion, 1 in the thoracic cord and 1 in the bulb-cervical cord. Conclusions Total tumor removal can be achieved in most intramedullary ependymoma through early diagnosis and timely operation, and the prognosis is good. Total removal should not be pursued for tumors with severe adhesion. The neurological deficits should be easily aggravated if the preoperative neurological function is poor.
出处
《中国微侵袭神经外科杂志》
CAS
北大核心
2010年第3期99-102,共4页
Chinese Journal of Minimally Invasive Neurosurgery
