多节段髓内星形细胞瘤的临床研究

目的 探讨不同年龄段、恶性程度不同的多节段髓内星形细胞瘤患者的诊治特点.方法 21例多节段(3个椎体节段以上)髓内星形细胞瘤患者均行后正中入路显微镜下肿瘤切除术,以UOA分值差(术后UOA和术前UOA差值)评估手术效果.以Logistic回归和多元线性同归分析统计学数据.结果 肿瘤性质直接影响肿瘤的切除程度(X2=10.41,P=0.03),高度恶性肿瘤只能大部切除或减压.年龄(X2=12.53,P=0.01)、肿瘤性质(X2=16.44,P=0.002)和部位(X2=27.12,P=0.04)影响近期手术效果(UOA分值差);青少年患者、低度恶性肿瘤手术效果较好,单纯累及胸段的患者手术效果差.结论 低度恶性或青少年多节段髓内星形细胞瘤患者应尽早手术,术后疗效满意.

Clinical study on microsurgical treatment for multl-segment intramedullary astrocytomas

Objective This clinical study was aimed to distinguish the difference between benign and malignant multi-segment intramedullary astrocytomas for micresurgery,and to analyze clinical features of adolescent and adult patients.Methods 21 patients with multi-segment intramedullary astrocytomas underwent tumor removal microsurgery through a posterior approach.Preoperative and postoperative nervous functions were scored using the Improved JOA (IJOA) grading system Pearson correlation coefficients and Logistic regression were performed between functional outoome (IJOA score differences) and histological features,gender,age,tuner location,remove extent,and longitudinal extent of spinal cord involvement.Results The histological feature of tuners was the most important factor influencing the extent of surgical removal (X2=10.41,P=0.03)The age of patients (X2=12.53,P=0.01),histological features (X2=16.44,P=0.002) and Iocation(x2=27.12,P=0.04)of tumors were important factors influencing the recent treatment outcome.Conclusions We stress the importance of early microsurgical treatment for low-grade malignant multi-segment intuamedullary astrecytomas,especially for adolescent patients,usually followed by goad outcomes.