脊髓髓内肿瘤的手术治疗

目的：探讨各种病理类型的脊髓髓内肿瘤临床和影像学的鉴别诊断，肿瘤囊腔及其空洞的形成机理，脊髓前动脉在病理状态下的作用及各种肿瘤的手术切除技巧。方法：系统分析了经显微手术切除的１０４例（１１６个）髓内肿瘤，包括室管膜瘤，星形细胞瘤，血管网状细胞瘤等十余种病理类型的临床资料，并进行了动物脊髓血管闭塞模型的研究。结果：全组无手术死亡率，亦无手术致残者。绝大多数病人得到满意疗效，并保证了患者良好的术后存活质量。结论：对于绝大多数髓内肿瘤，显微外科手术治疗是目前最根本的治疗方法。强调早期治疗及对不同肿瘤采取相应的微创性手术技巧。对于那些疯狂侵润性生长的恶性肿瘤，要考虑一定剂量的常规放射治疗。

Surgical treatment of the intramedullary spinal cord tumors

Objective:To discuss the differential diagnosis of various kinds of intramedullary spinal cord tumors according to clinical and neuroimage data, the pathogenesis of formation of the tumor's cyst and syringomyelia, the function of the anterior spinal artery in pathological condition, and the surgical technique of these tumors. Methods: Analysis has been made of the clinical data of 104 patients with 116 intramedullary apinal cord tumors resected by microneurosurgery, including ependymoma, astrocytoma, hemangioblastoma, etc. The research of obliterated spinal vessels has also been made in animals. Results: Most of the cases have achieved excellent result and satisfactory living quality. There is no operative mortality and severe morbidity. Conclusion: The best treatment of most intramedullary cord tumors is active micro neurosurgery at present. It is very important to give such minimal invasive operation as sooner as possible in order to gain a good result. As to those malignant tumors with further infiltration, radio therapy is also considered as a routine therapy.