摘要
目的探讨脊髓髓内海绵状血管瘤的显微手术治疗效果。方法回顾性分析2003年1月一2017年3月经显微手术治疗的脊髓髓内海绵状血管瘤23例患者的临床资料。采用McCormick临床神经功能分级方法及MRI检查．对患者术前和术后的神经功能及影像学改变进行分析。出院后间隔6～12个月复查MRI及评估神经功能情况。结果22例全切除病灶，1例大部分切除。出院时17例症状好转甚至完全消失，4例无明显改善．2例较术前加重．无死亡病例。随访成功2l例，随访时间3个月-9年，未见肿瘤复发。术前14例临床神经功能Ⅰ-Ⅱ级患者中10例术后恢复较快．症状大部分好转甚至消失，3例无明显变化，1例症状加重；7例Ⅲ-Ⅳ级患者中6例术后恢复较慢．仍存在不同程度神经功能障碍，1例无变化。按术前神经功能Ⅰ-Ⅱ级和Ⅲ-Ⅳ级分组，比较患者的治疗效果，差异有统计学意义（xz=5．25，P〈0．05）。结论显微手术切除脊髓髓内海绵状血管瘤安全有效．术前神经功能情况、肿瘤与脊髓的关系及手术技巧与切除程度等是影响预后的重要因素。
Objective To investigate the microsurgical effect of spinal cord Intramedullary cavernous heman- gioma. Methods The clinical data of 23 patients with spinal cord Intramedullary cavernous bemangioma from Jan- uary, 2003 to March, 2017 were analyzed retrospectively. McCormick clinical neurological function classification method and MRI examination were used to analyze the changes of neurological function and imaging changes before- and-after operation. MRI and assess nerve function were reviewed 6-12 months after discharge. Results Twenty- two cases were totally resected, and subtotal excised in 1 case. The symptoms improved and even disappeared com- pletely in 17 cases. There was no obvious improvement in 4 cases, 2 cases were worse and no death cases. Twenty- one cases were followed-up. The follow-up time was 3 months-9 years, and no tumor recurrence was found. Among the 14 cases of clinical neurological function I-II, 10 cases recovered rapidly and most of the symptoms improved or even disappeared. Three cases had no obvious change. The other 1 case aggravated symptoms; Six cases of III-IV pa- tients in 7 cases of postoperative recovery, and 1 case of no change. According to preoperative neurological function grade Ⅰ-Ⅱ and Ⅲ-Ⅳ, the treatment effect of patients was compared, the difference was significant （X^2=5.25,P〈O.05）. Conclusion Microsurgical resection of spinal cord Intramedullary cavernous hemangioma is safe and effective. The preoperative nerve function, the relationship between the tumor and the spinal cord, and the surgical skill and the de-
作者
董伟杰
刘馨蔓
苏月焦
陈昆
郭少雷
吴新建
Dong Weijie;Liu Xinman;Su Yuejiao;Chert Kun;Guo Shaolei;Wu Xinjian(Department of Neurosurgery, the First Affiliated Hospital of Sun Yat-sen Uni- versity, Guangzhou 510080, China)
出处
《中华显微外科杂志》
CSCD
北大核心
2018年第2期105-108,共4页
Chinese Journal of Microsurgery
基金
广东省自然科学基金（S2013010015837）
关键词
脊髓
海绵状血管瘤
显微外科手术
Spinal cord
Cavernous hemangioma
Microsurgical operation
