[1]刘亚军　王金龙　郭运发　罗　坤.高颈段椎管内肿瘤的显微手术治疗[J].中国临床神经外科杂志,2017,(12):804-807.[doi:10.13798/j.issn.1009-153X.2017.12.002]
　LIU Ya-jun,WANG Jin-long,GUO Yun-fa,et al.Microneurosurgery for high cervical intraspinal tumors (report of 50 cases)[J].,2017,(12):804-807.[doi:10.13798/j.issn.1009-153X.2017.12.002]
点击复制

高颈段椎管内肿瘤的显微手术治疗()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年12期
页码:
804-807
栏目:
论著
出版日期:
2017-12-25

文章信息/Info

Title:
Microneurosurgery for high cervical intraspinal tumors (report of 50 cases)
文章编号:
1009-153X（2017）12-0804-04
作者:
刘亚军　王金龙　郭运发　罗　坤
作者单位：830054 乌鲁木齐，新疆医科大学第一附属医院神经外科中心（刘亚军、王金龙、郭运发、罗　坤）
Author(s):
LIU Ya-jun;  WANG Jin-long;  GUO Yun-fa;  LUO Kun.
Department of Neurosurgery, the First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054, China
关键词:
椎管内肿瘤; 高颈段椎管; 显微手术; 颈椎稳定性; 疗效
Keywords:
High cervical intraspinal tumors;  Microneurosurgery;  Stability of cervical spine;  Curative effect
分类号:
R 739.42; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2017.12.002
文献标志码:
A
摘要:
目的 探讨高颈段椎管内肿瘤显微手术方法的选择及其疗效。方法 回顾性分析2010年1月至2016年12月显微手术治疗的50例高颈段椎管内肿瘤的临床资料，其中26例在半椎板切除条件下行切除肿瘤；24例在全椎板切除条件下切除肿瘤，术后再应用内固定。结果 术后病理示神经鞘瘤23例，脊膜瘤16例，室管膜瘤8例，星形细胞瘤2例，血管母细胞瘤1例。肿瘤全切42例，次全切8例。术后7例出现并发症，其中6例对症处理好转出院，1例死亡。49例术后随访3个月至3年，未见肿瘤复发，脊柱稳定性好；按日常生活活动能力量表评价预后状况，术后生活质量改善39例，无变化7例，下降3例；8例次全切残余肿瘤体积无明显变化，其余无复发；所有病人随访期间影像学检查无颈椎不稳现象。结论 应用神经显微技术切除高颈段椎管内肿瘤效果好，可减少神经损伤并发症。在维持颈椎稳定性方面，要根据占位与脊髓的位置关系选择手术方式。
Abstract:
【Abstract】Objective To explore microneurosurgical technique to treat high cervical intraspinal tumors. Methods The clinical data of 50 patients with high cervical intraspinal tumors, of whom, 26 underwent half laminectomy and resection of the tumors and 24 the laminectomy, resection of the tumors and internal fixation, from January, 2010 to December, 2016, were analyzed retrospectively. Results The postoperative pathological examination showed that of these 50 patients, 23 had neurilemmomas, 16 spinal meningiomas, 8 ependymomas, 2 astrocytomas and 1 hemangioblastoma. Total resection of the tumors was achieved in 42 patients and subtotal resection in 8. The postoperative complications occurred in 7 patients, of whom, 6 were cured and 1 died. No tumor recurrence was observed and spinal stability is good in 49 patients who were followed up from 3 months to 3 years. The postoperative quality of life was improved in 39 cases, unchanged in 7 and decreased in 3 during the following up according to activities of daily living test. Conclusions The curative effects of microneurosurgery on the patients with high cervical intraspinal tumors are good, but the surgical procedure should be selected according to the location of the intraspinal tumors in order to maintain the stability of the cervical spine.

参考文献/References:

[1] 郝　鸣，赵洪洋. 高颈段椎管内肿瘤显微手术治疗效果及 轴性症状相关因素分析[J]. 中华脑科疾病与康复杂志 （电子版），2015，5（5）：18-22. [2] 张　力，靳安民，舒小秋，等. 高位颈段椎管内肿瘤的手术 治疗[J]. 实用骨科杂志，2009，15（10）：773-775. [3] Binanti D, De Zani D, Fantinato E, et al. Intradural-extra- medullary haemangioblastoma with paraspinal extension in a dog [J]. Aust Vet J, 2015, 93 (12): 460-465. [4] 陈海锋，李　丹，王跃龙，等. 颈椎哑铃型肿瘤的临床分型 及手术人路的选择[J]. 中华医学杂志，2014，94（19）： 1444-1447． [5] 陈　彬，陈治标. 神经电生理监测辅助下显微手术治疗高 颈段椎管内肿瘤[J]. 中国临床神经外科杂志，2016，21 （10）：596-597. [6] 刘　祺，赵　冬，许　晖，等. 显微手术治疗25例延颈交 界区肿瘤[J]. 中华神经外科杂志， 2015，31（2）：146-149. [7] 苏旭明，张学新，刘海英，等. 半椎板切除在上颈段椎管内 神经鞘瘤手术中的应用[J]. 中国临床神经外科杂志， 2017，22（3）：145-148. [8] Molinari R, Bessette M, Raich A, et al. Vertebral artery anomaly and injury in spinal surgery [J]. Evid Based Spine Care J, 2014, 5(1)：16-27. [9] Montano N, Trevisi G, Cioni B, et al. The role of lamino- plasty in preventing spinal deformity in adult patients submitted to resection of an intradural spinal tumor: case series and literature review [J]. Clin Neurol Neurosurg, 2014, 125: 69-74. [10] 江泽华，邵高升，张学利. 脊柱稳定性重建在椎管肿瘤手 术中的应用进展[J]. 中华临床医师杂志（电子版），2013， （13）：154-155. [11] 车晓明，徐启武. 椎管内外生长的神经鞘瘤规范化手术治 疗策略[J]. 中国神经精神疾病杂志，2009，35（1）：1-2. [12] Angevine PD, Kellner C, Haque RM, et al. Surgical mana- gement of ventral intradural spinal lesions [J]. J Neurosurg Spine, 2011, 15(1): 28-37.

相似文献/References:

[1]赵东升　王正君　孙刚锋　费　舟　姬西团　李　娟　万晓强.椎管内畸胎瘤的诊断与治疗[J].中国临床神经外科杂志,2015,(11):661.[doi:10.13798/j.issn.1009-153X.2015.11.007]
　ZHAO Dong-sheng,WANG Zheng-jun,SUN Gang-feng,et al.Dignosis and treatment of intraspainal teratomas[J].,2015,(12):661.[doi:10.13798/j.issn.1009-153X.2015.11.007]
[2]张治元　王汉东　成惠林　赵　鑫　林毅兴　朱　林.神经电生理监测下椎管内肿瘤的显微外科治疗[J].中国临床神经外科杂志,2015,(11):668.[doi:10.13798/j.issn.1009-153X.2015.11.009]
　ZHANG Zhi-yuan,WANG Han-dong,CHENG Hui-lin,et al.Microsurgery for intraspinal tumors under electrophy- siological monitoring[J].,2015,(12):668.[doi:10.13798/j.issn.1009-153X.2015.11.009]
[3]张　嘉　王振宇　林国中　于　涛.椎管内血液系统肿瘤的诊治分析（附7例报道）[J].中国临床神经外科杂志,2016,(01):13.[doi:10.13798/j.issn.1009-153X.2016.01.005]
　ZHANG Jia,WANG Zhen-yu,LIN Guo-zhong,et al.Diagnosis and treatment of intraspinal blood system tumor (report of 7 cases)[J].,2016,(12):13.[doi:10.13798/j.issn.1009-153X.2016.01.005]
[4]高　俊,李智敏,王天宇,等.成人椎管内先天性肿瘤的手术治疗[J].中国临床神经外科杂志,2016,(11):670.[doi:10.13798/j.issn.1009-153X.2016.11.006]
　GAO Jun,LI Zhi-min,WANG Tian-yu,et al.Surgical treatment of intraspinal congenital neoplasms in adult patients[J].,2016,(12):670.[doi:10.13798/j.issn.1009-153X.2016.11.006]
[5]田学丰,冯春国,王先祥,等.脊柱内固定技术在切除多节段椎管内肿瘤中的应用（附12例报道）[J].中国临床神经外科杂志,2016,(11):673.[doi:10.13798/j.issn.1009-153X.2016.11.007]
　TIAN Xue-feng,FENG Chun-guo,WANG Xian-xiang,et al.Application of intraspinal internal fixation to microneurosurgery for multilevel spinal tumors (report of 12 cases)[J].,2016,(12):673.[doi:10.13798/j.issn.1009-153X.2016.11.007]
[6]谢天浩 综述　骆　纯　马廉亭 审校.颈椎椎管内肿瘤切除术中全椎板切除致颈椎畸形的危险因素及防治措施[J].中国临床神经外科杂志,2017,(01):58.[doi:10.13798/j.issn.1009-153X.2017.01.024]
[7]赵焱,程立冬,徐志强,等.巨大型椎管内肿瘤的显微手术治疗[J].中国临床神经外科杂志,2017,(07):483.[doi:10.13798/j.issn.1009-153X.2017.07.012]
　ZHAO Yan,CHENG Li-dong,XU Zhi-qiang,et al.Microsurgery for giant intraspinal tumors (report of 22 cases)[J].,2017,(12):483.[doi:10.13798/j.issn.1009-153X.2017.07.012]
[8]谢　涛　刘　羽　毛　峰　叶　飞.椎管内血管外皮细胞瘤1例[J].中国临床神经外科杂志,2017,(11):799.[doi:10.13798/j.issn.1009-153X.2017.11.025]
[9]吴胜梅　张桂萍　肖　姗　秦秀萍　王桂花　王　萍.1例高颈段髓内室管膜瘤术后并发呼吸机依赖1年的护理体会[J].中国临床神经外科杂志,2017,(12):856.[doi:10.13798/j.issn.1009-153X.2017.12.020]
[10]李　宁　张　帆　尚亚军　王　波　杨智勇　宋晓斌.椎管内畸胎瘤并骶管囊肿致脊髓栓系1例[J].中国临床神经外科杂志,2018,(11):766.[doi:10.13798/j.issn.1009-153X.2017.11.024]

备注/Memo

备注/Memo:
基金项目：国家自然科学基金（81660471）
更新日期/Last Update: 2017-12-27