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目的 :总结椎管内髓外硬膜下肿瘤的临床特点及病理学构成情况。方法 :对2006年1月~2014年8月本院脊柱外科收治的167例、平均年龄49.5岁的椎管内髓外硬膜下肿瘤患者的一般情况、影像学资料和病理诊断进行回顾性的统计分析。结果:髓外硬膜下肿瘤女性∶男性比例为1.17∶1,167例患者中75.6%存在疼痛症状,40.1%存在感觉障碍,34.9%存在运动障碍,4.4%合并有大小便功能障碍。髓外硬膜下肿瘤患者中有120例神经鞘瘤,34例脊膜瘤,其他类型肿瘤相对较少。神经鞘瘤患者的平均年龄为47.3±1.3岁,脊膜瘤患者的平均年龄为57.5±2.6岁;神经鞘瘤患者男女比例为1.14∶1,脊膜瘤患者女性∶男性比例为5.8∶1,两者差异具有统计学意义(P<0.001)。神经鞘瘤好发于胸腰段(47.9%),脊膜瘤好发于胸段(35.3%)。神经鞘瘤和脊膜瘤的根性疼痛症状所占比例分别为67.5%和35.3%,感觉障碍症状为28.2%和76.5%,肌力减退症状为25.6%和73.5%,均有显著性差异(分别为P=0.001,P<0.001,P<0.001)。神经鞘瘤和脊膜瘤的体积无显著性差异(P>0.05)。在肿瘤体积在10cm3以内的亚组分析中,神经鞘瘤的平均体积为(3.5±2.2)cm3,脊膜瘤的平均体积为(2.3±1.8)cm3,两者具有显著性差异(P=0.005)。结论:椎管内髓外硬膜下肿瘤主要以神经鞘瘤和脊膜瘤为主。脊膜瘤的平均发病年龄比神经鞘瘤大;神经鞘瘤好发于胸腰段,脊膜瘤好发于胸段;神经鞘瘤的症状以根性疼痛为主,脊膜瘤的症状以感觉和运动障碍为主。
Objective: To summarize the clinical characteristics and pathological constitution of spinal subdural extramedullary tumors. Methods: From January 2006 to August 2014 in our hospital spinal surgery admitted 167 cases, mean age 49.5 years of spinal subdural extramedullary tumors in patients with general conditions, imaging data and pathological diagnosis retrospective Statistical Analysis. Results: Extramedullary subdural tumors of women: the male ratio was 1.17: 1, 75.6% of the 77 patients had pain symptoms, 40.1% had sensory disturbances, 34.9% had dyskinesia, and 4.4% had stool dysfunction. Extramedullary subdural tumors in 120 patients with schwannoma, 34 cases of meningiomas, other types of tumors are relatively small. The average age of patients with schwannoma was 47.3 ± 1.3 years and the mean age of patients with meningioma was 57.5 ± 2.6 years. The ratio of male to female patients with schwannoma was 1.14:1. For men with meningioma, the male ratio was 5.8:1. The difference between the two groups was statistically significant (P <0.001). Schwannomas occur predominantly in the thoracolumbar region (47.9%) and in the thoracic region (35.3%). Schwannoma and meningiomas had a prevalence of 67.5% and 35.3% respectively, sensory disturbances 28.2% and 76.5%, and muscle weakness 25.6% and 73.5%, respectively P = 0.001, P <0.001, P <0.001). There was no significant difference in the size of schwannoma and meningioma (P> 0.05). In a subgroup analysis of tumor volume within 10 cm3, the average size of schwannoma was (3.5 ± 2.2) cm3 and the average volume of meningioma was (2.3 ± 1.8) cm3, with significant difference (P = 0.005 ). Conclusion: Subdural extramedullary subdural tumors are mainly schwannoma and meningioma. Meningioma average age of onset than schwannoma; Schwannoma occur in the thoracolumbar, meningioma occur in the thoracic; schwannomas symptoms of radical pain, meningioma symptoms to feel And dyskinesia-based.