【摘要】：目的：分析脊髓圓錐部髓內(nèi)腫瘤的臨床特點,探討顯微手術(shù)治療圓錐部髓內(nèi)腫瘤的進展。 材料與方法：回顧性分析2010年12月至2013年11月我院收治的脊髓圓錐部髓內(nèi)腫瘤患者,總結(jié)其流行病學特點、臨床癥狀及體征、腫瘤病理類型,不同治療方式及其各自臨床療效,歸納脊髓圓錐部髓內(nèi)腫瘤的臨床特點及其治療進展。 結(jié)果：本組共有24例患者,其中男性11例,女性13例,年齡22～71歲,平均年齡46.58±14.97歲,病程1月-20年,平均3年。本組患者以根性疼痛、感覺障礙、肌力障礙、大小便障礙為主要臨床表現(xiàn)。所有患者均行手術(shù)治療,其中髓內(nèi)囊腫開放囊腔及切除部分囊壁,其余腫瘤行腫瘤切除術(shù)。術(shù)后病理提示室管膜瘤8例,占總數(shù)的33.33%,其次神經(jīng)鞘瘤5例,蛛網(wǎng)膜囊腫4例,脂肪瘤2例,海綿狀血管瘤、血管母細胞瘤、星形膠質(zhì)細胞瘤、惡性淋巴瘤、神經(jīng)纖維瘤各1例。隨訪3月-3年,病情較術(shù)前明顯改善者19例,達79.16%,穩(wěn)定者3例,死亡2例。 結(jié)論：根性疼痛及感覺障礙是圓錐部髓內(nèi)腫瘤的最主要臨床表現(xiàn),同時常伴有大小便功能障礙；MRI是圓錐部髓內(nèi)腫瘤的首選檢查方法,對手術(shù)方案的設(shè)計具有重要指導(dǎo)作用；圓錐部髓內(nèi)腫瘤以室管膜瘤、神經(jīng)鞘瘤和囊腫最為多見；顯微手術(shù)是目前治療圓錐部髓內(nèi)腫瘤唯一有效的方法,放化療仍是圓錐部髓內(nèi)惡性腫瘤的一種重要輔助治療。
[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.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R739.4

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