显微手术治疗脊髓髓内胶质瘤23例

目的:分析23例脊髓髓内胶质瘤显微手术治疗经验,评价其疗效和预后。方法:对9年来经显微手术治疗的23例脊髓髓内胶质瘤患者的肿瘤病理类型、肿瘤部位、临床症状、体征、辅助检查和临床疗效进行回顾性分析研究。结果:本组13例星形细胞瘤(56.5%)及10例室管膜瘤(43.5%),均于显微镜下肉眼全切除,全组无围手术期死亡。16例随访2个月至7.6年平均(38±11)个月]。末次随访结束时(失访者按出院前的神经功能评定):肌力改善16例(69.6%)、不变2例(8.7%)、加重2例(8.7%)及死亡3例(13.0%)。随访中复发5例。结论:脊髓髓内胶质瘤宜早诊断并尽早接受手术治疗。显微神经外科技术可提高肿瘤全切,改善脊髓髓内胶质瘤的预后。星形细胞瘤应及时进行术后放疗和化疗。

Micosurgical Treatment of Intramedullary Gliomas: a Review of 23 Cases

Aim:To evaluate the results of microsurgical treament of 23 cases with intramedullary gliomas. Methods:23 cases of intramedullary gliomas operated by author in last 9 years were analysed retrospectively,which including the tumors histological,locations,tumor removal rates and operative outcome. Results:In our group,astrocytoma was most common(56.5%) ,ependymoma was(43.5%) . Tumor total removal was in all cases. There were no deaths due to surgery. 16 cases were followed-up for 2 months to 88 months with an average of 38 months.When comparing the preoperative and follow-up functional grades,69. 6% improved,8.7% remained the same,and 8.7% deteriorated and 3 cases(13.0%) died;5 cases recurred. Couclusion:Intramedullary gliomas needs operative therapy as earlier as possible and it should be to total resection. Intraspinal astrocytoma should be to chemical and radiant therapies betimes.