显微手术和非显微手术治疗椎管内肿瘤100例的比较分析

目的比较非显微手术与显微手术治疗椎管内肿瘤的临床疗效及术后恢复情况。方法回顾性分析100例椎管内肿瘤患者的临床资料,对非显微手术组与显微手术组的治疗效果进行了比较分析。结果 A组(显微手术组)手术时间(3.9±0.8)h,出血量(414±87)ml,脑脊液漏发生2例(发生率4.0%),平均住院时间(13±3)d;B组(非显微手术组)手术时间(2.1±0.5)h,出血量(680±106)ml,脑脊液漏发生9例(发生率18.0%),平均住院时间(22±13)d。A组有47例患者肿瘤全切除(全切率94%),B组全切除肿瘤仅34例(全切率68%)。A组中疼痛患者有93.3%有所缓解;感觉障碍的患者有76.5%得到不同程度的缓解,2例加重;运动障碍的患者都得到不同程度的改善;尿潴留或尿失禁患者有86.7%得以缓解。B组中疼痛患者仅有63.6%症状有所缓解;感觉障碍的患者有54.2%得到不同程度的缓解;运动障碍的患者有55%得到不同程度的改善;尿潴留或尿失禁患者仅45.5%得以缓解。可见显微手术组各方面均优于非显微手术组(P<0.05)。术后随访时间为6个月~3年,平均随访时间28.3个月,随访率76%。A组随访患者术后未见并发症发生;B组随访患者术后肿瘤复发6例,继发性椎管狭窄5例。结论显微手术治疗椎管内肿瘤具有创伤小、安全性高等优点。显微手术是治疗椎管内肿瘤的有效方法。

Comparative analysis of microsurgery and non-microsurgery in 100 cases of intraspinal tumors

Objective To compare the clinical efficacy and postoperative recovery of microsurgery and non-microsurgery for intraspinal tumors. Methods The clinical data of 100 patients with intraspinal tumors were analyzed retrospectively. The therapeutic outcomes of two types of treatment were compared. Results In microsurgery group （ Group A） and non-microsurgery group （ Group B）, the operation time were （ 3.9 ± 0.8） h and （2.1 ± 0.5 ） b, hemorrhage were （ 414 ± 87 ） ml and （ 680 ± 106） ml, leakage of cerebrospinal fluid occurred in 2 （4.0%） and 9 （ 18.0% ） patients. The mean days of hospitalization were （ 13 ± 3） d and （22 ± 13） d. total resection of tumors performed in 47 cases （94%） and 34 cases （68%）. The rate of easement of pain at 93.3% and 63.6% in pain patients, 76.5% and 54.2% of patients with sensory disability felt better except 2 cases with deterioration in Group A. 100% and 55% of patients with dyskinesia felt better, 86.7% and 45.5% in patients with urinary retention or incontinence. The therapeutic outcomes in microsurgery group were better than in non-microsurgery group （ P 〈 0.05 ）. Patients were followed up for 6 months to 3 years （ average 28.3 ） , the follow-up rate was 76%. No complication occurred in Group A. Tumor recurrence and spinal stenosis occurred in 6 cases and 5 cases during follow-up in Group B. Conclusion Small trauma and high security are advantages of the microsurgical technique, and the mierosurgical technique is effective in treating intraspinal tumors.