[1]谢湘涛** 胡朝晖.放大镜下颈胸段原发性椎管内肿瘤切除术112例报告[J].中国微创外科杂志,2019,01(11):1007-1011.
　Xie Xiangtao,Hu Zhaohui..Resection of Primary Intraspinal Tumors in Cervicothoracic Region Under Magnifying Glass: Report of 112 Cases[J].Chinese Journal of Minimally Invasive Surgery,2019,01(11):1007-1011.
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放大镜下颈胸段原发性椎管内肿瘤切除术112例报告()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2019年11期
页码:
1007-1011
栏目:
临床研究
出版日期:
2019-11-25

文章信息/Info

Title:
Resection of Primary Intraspinal Tumors in Cervicothoracic Region Under Magnifying Glass: Report of 112 Cases
作者:
谢湘涛** 胡朝晖
(广西柳州市人民医院脊柱外科，柳州545006)
Author(s):
Xie Xiangtao;  Hu Zhaohui.
Department of Spinal Surgery, Liuzhou People’s Hospital, Liuzhou 545006, China
关键词:
椎管内肿瘤; 放大镜
Keywords:
Intraspinal tumor; Magnifying glass
文献标志码:
A
摘要:
目的探讨放大镜下颈胸段椎管内肿瘤切除术的安全性和效果。方法回顾性分析2013年1月~2017年12月112例颈胸段原发性椎管内肿瘤的资料，颈段64例，胸段48例；髓内25例，髓外硬膜下76例，硬膜外11例；长径1~9 cm，平均3.6 cm。美国脊髓损伤协会（American Spinal Injury Association，ASIA）神经功能评级A级6例，B级10例，C级17例，D级77例，E级2例。均在眼镜式2.5倍放大镜下切除，均获1年以上随访。结果肿瘤全切或次全切98例，大部分切除14例。术后病理神经鞘瘤55例，脊膜瘤30例，室管膜瘤9例，星形细胞瘤6例，脂肪瘤和表皮样囊肿各4例，血管瘤和肠源性囊肿各2例。随访12~72个月，平均23.5月。复发16例，其中再手术12例。术前术后均无症状2例，其余110例至末次随访时疼痛麻木症状消失78例，减轻21例，无改善9例，加重2例。ASIA神经功能评级提高1级91例，2级12例，降级2例，不变7例。结论原发性椎管内肿瘤大多为良性，手术效果好，放大镜下显微手术能较好地切除肿瘤，同时能以微创方法减少对正常组织的干扰，保持脊柱的稳定性。
Abstract:
ObjectiveTo investigate the safety and therapeutic effect of intraspinal tumor resection in cervicothoracic region under the magnifying glass.MethodsA retrospective analysis was given to 112 cases suffered from primary intraspinal tumor in cervicothoracic canal from January 2013 to December 2017. There were 64 cases of cervical segment and 48 cases of thoracic segment lesions. There were 25 cases of intramedullary, 76 cases of extramedullary epidural and 11 cases of epidural lesions. The long diameter was 1-9 cm, with an average of 3.6 cm. Among them, 6 cases were rated as grade A, 10 cases as grade B, 17 cases as grade C, 77 cases as grade D, and 2 cases as grade E by the American Spinal Injury Association (ASIA) Classification. All the operations were performed under a glassestype 2.5time magnifying glass and all the cases were followed up for more than 1 year.ResultsTotal or subtotal resection were performed in 98 cases and partial resection in 14 cases. There were 55 cases of schwannoma, 30 cases of meningioma, 9 cases of ependymoma, 6 cases of astrocytoma, 4 cases of lipoma，4 cases of epidermoid cyst, 2 cases of hemangioma, and 2 cases of intestinal cyst. Followup ranged from 12 to 72 months, with an average of 23.5 months. There were 16 cases of recurrence, including 12 cases of reoperation. There were 2 cases without symptoms before and after operation. In the remaining 110 cases, the pain and numbness disappeared at the last followup in 78 cases, were relieved in 21 cases, were not improved in 9 cases, and were aggravated in 2 cases. The ASIA neurological function rating was improved by one grade in 91 cases and two grades in 12 cases, with 2 cases downgraded and 7 cases unchanged.ConclusionsMost of primary intraspinal tumors are benign, with good surgical results. Microsurgery under magnifying glass can excise tumors well. Meanwhile, minimally invasive methods can reduce the interference to normal tissues and maintain the stability of the spine.

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备注/Memo

备注/Memo:
基金项目：国家自然科学基金（81260274）；广西卫健委自筹基金（Z20190168）**通讯作者，Email：drxxt@126.com
更新日期/Last Update: 2020-03-03