脊髓圆锥部髓内肿瘤的临床特点及其显微手术治疗

发布时间：2018-09-18 16:45

【摘要】：目的：分析脊髓圆锥部髓内肿瘤的临床特点,探讨显微手术治疗圆锥部髓内肿瘤的进展。材料与方法：回顾性分析2010年12月至2013年11月我院收治的脊髓圆锥部髓内肿瘤患者,总结其流行病学特点、临床症状及体征、肿瘤病理类型,不同治疗方式及其各自临床疗效,归纳脊髓圆锥部髓内肿瘤的临床特点及其治疗进展。结果：本组共有24例患者,其中男性11例,女性13例,年龄22～71岁,平均年龄46.58±14.97岁,病程1月-20年,平均3年。本组患者以根性疼痛、感觉障碍、肌力障碍、大小便障碍为主要临床表现。所有患者均行手术治疗,其中髓内囊肿开放囊腔及切除部分囊壁,其余肿瘤行肿瘤切除术。术后病理提示室管膜瘤8例,占总数的33.33%,其次神经鞘瘤5例,蛛网膜囊肿4例,脂肪瘤2例,海绵状血管瘤、血管母细胞瘤、星形胶质细胞瘤、恶性淋巴瘤、神经纤维瘤各1例。随访3月-3年,病情较术前明显改善者19例,达79.16%,稳定者3例,死亡2例。结论：根性疼痛及感觉障碍是圆锥部髓内肿瘤的最主要临床表现,同时常伴有大小便功能障碍；MRI是圆锥部髓内肿瘤的首选检查方法,对手术方案的设计具有重要指导作用；圆锥部髓内肿瘤以室管膜瘤、神经鞘瘤和囊肿最为多见；显微手术是目前治疗圆锥部髓内肿瘤唯一有效的方法,放化疗仍是圆锥部髓内恶性肿瘤的一种重要辅助治疗。
[Abstract]:Objective: To analyze the clinical features of intramedullary tumors of conus medullaris and to explore the progress of microsurgical treatment of intramedullary tumors of conus medullaris.
Materials and Methods: The epidemiological characteristics, clinical symptoms and signs, pathological types, different treatment methods and their respective clinical effects of intramedullary tumors of the conus medullaris in our hospital from December 2010 to November 2013 were analyzed retrospectively. The clinical characteristics and treatment progress of intramedullary tumors of the conus medullaris were summarized.
Results: There were 24 patients in this group, including 11 males and 13 females, aged 22-71 years, with an average age of 46.58 (+ 14.97). The course of the disease ranged from 1 month to 20 years with an average of 3 years. Postoperative pathology revealed 8 cases of ependymoma, accounting for 33.33% of the total, followed by 5 cases of neurilemmoma, 4 cases of arachnoid cyst, 2 cases of lipoma, 1 case of cavernous hemangioma, hemangioblastoma, astrocytoma, malignant lymphoma and 1 case of neurofibroma. There were 19 cases, 79.16% cases, 3 cases of stability and 2 cases of death.
Conclusion: Root pain and sensory disturbance are the most important clinical manifestations of intramedullary tumors of the cone, accompanied by dysfunction of urine and urine; MRI is the preferred method of examination for intramedullary tumors of the cone, which plays an important guiding role in the design of surgical procedures; ependymoma, neurilemmoma and cyst are the most common intramedullary tumors of the cone. Microsurgery is the only effective method for the treatment of intramedullary tumors in the cone. Radiotherapy and chemotherapy are still an important adjuvant therapy for intramedullary tumors in the cone.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.4

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