脊髓髓内肿瘤36例显微外科术后随访与观察

目的：探讨运用显微外科技术切除脊髓髓内肿瘤的方法、技巧和临床效果。方法：对我院神经外科手术治疗的36例脊髓髓内肿瘤患者的病历资料进行回顾性分析，对肿瘤部位、病理类型、手术切除程度、手术前后临床症状和体征变化进行长期随访。结果：室管膜瘤的全切除率为87．5％，近全切除及大部切除率12．5％；星形细胞瘤的全切除率为33．3％．近全切除及大部切除率33．3％，部分切除及椎管减压者33．3％；海绵状血管瘤的全切除率为100％；表皮样囊肿的全切除率为60％，近全切除及大部切除率40％；其他肿瘤的全切除率为100％。33例(91．7％)病人获得2个月～11年随访，其中25例存活，8例死亡。结论：决定脊髓髓内肿瘤患者生存的主要因素是肿瘤病理特点．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．以取得较好手术疗效。

Long term follow-up of microsurgical treatment of 36 intramedullary spinal cord tumors

Objective: To study the microsurgical treatment and discuss the surgical stragey and technique for intramedullary spinal cord tumors. Methods: 36 patients with intramedullary spinal cord tumors were operated at neurosurgical department in our hospital. They were analyzed retrospectively with regard to tumor classification,location,removal extent and long -term results. Results: The total removal rate rate of ependymomas was 87.5%,subtotal removal rate of ependymomas is 12.5%. The total removal rate of astrocytomas was 33.3%,subtotal removal rate was 33.3%, partial removal rate was 33.3%. The total removal rate of cavernous angimoma was 100% . The total removal rate of epidermoid cyst was 60%, subtotal removal rate was 40%. The total removal rate of other tumors was 100%. 33 Patients were followed up for an period of 2 months to 11 years. 25 patients were alive and 5 died. Conclusion: The first factor affecting survival of patients with intramedullary spinal cord tumors is classficition ,and early operation is pathologic essential to better outcome.