脊髓髓内肿瘤显微手术疗效的长期随访

目的：总结脊髓髓内肿瘤的手术经验，对手术治疗脊髓髓内肿瘤的价值及疗效进行评价。方法：对两个神经外科中心手术治疗的123例脊髓髓内肿瘤进行回顾性分析，对肿瘤部位、病理类型、手术切除程度、手术 前后临床症状与体征的变化，进行长期随访，以评估手术疗效。结果：本组室管膜瘤占脊髓髓内肿瘤的34．1％，手术全切除率为90．5％，次全切除率为7．1％，部分切除及活检率为2．4％；星形细胞瘤占26．8％，全切除率为30．3％，次全切除率为39．4％，部分切除及活检率为30．3％；脂肪瘤占14．6％，全切除率为11．1％，次全切除率为38．9％，部分切除或活检率为50．0％；血管网状细胞瘤占10．6％，全切除率为76．9％，次全切除率为23．1％；其它肿瘤占13．9％，全切除率为82．4％，次全切除率为11．7％，部分切除及活检占5．9％。94例经平均38．6个月长期随访，89例存活，5例死亡。结论：脊髓髓内肿瘤以良性及低恶性度肿瘤多见，早期手术预后较好，应力争在脊髓功能未出现严重损害前手术，以争取得到较好的手术疗效。

Long-term follow-up of microsurgical treatment of intramedullary spinal cord tumours

Objective To study the microsurgical treatment and assess the value of the surgical treatment of intramedullary spinal cord tumors. Methods One hundred and twenty - three patients with intramedullary spinal cord tumor were operated at two neurosurgical centers in Tianjin. They were analyzed retrospectively with regard to tumor classification, location, removal extent and long -term results. Results Ependymomas accounted for 34. 1% in intramedullary spinal cord tumors with a total removal rate of 90. 5% , subtotal removal rate of 7.1% , and partial removal or biopsy rate of 2. 4%. Astrocytomas accounted for 26. 8% with a total removal rate of 30.3% , subtotal removal rate of 39.4% and partial removal or biopsy rate of 30.3%. Lipomas accounted for 14.6% , with a total removal rate of 11.1%, subtotal removal rate of 38.9% , and partial removal or biopsy rate of 50.0%. Hemangioblastomas accounted for 10. 6% with a total removal rate of 76.9% and subtotal removal rate of 23.1%. Others accounted for 13. 9% with a total removal rate of 82.4% , subtotal removal rate of 11.7% , and partial removal or biopsy rate of 5.9%. Ninety - four patients were followed up for an average of 38.6 months. Eighty - nine patients were alive and 5 died. Conclusion Benign tumors and low grade malignant tumors are commonly seen in intramedullary spinal cord tumors, and early operation is essential to better outcome.