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目的:探讨脊髓髓内肿瘤诊断与手术治疗方法。方法:回顾性分析17例脊髓髓内肿瘤患者临床特征、诊断标准及手术方法与疗效。结果:确诊为室管膜瘤8例、星形细胞瘤5例、海绵状血管瘤2例、脂肪瘤2例,16例采取后正中入路、1例经肋骨-横突入路;肿瘤全切除12例、次全切除2例、部分切除3例,手术后症状、体征改善者9例,稳定者5例,加重者2例,死亡1例。结论:脊髓髓内肿瘤好发于成年人,男性多见,病程长且多见于颈段,MRI对脊髓髓内肿瘤诊断特异性高。手术方法随肿瘤类型不同而异;对恶性和未全切除肿瘤放疗疗效良好。
Objective: To investigate the diagnosis and surgical treatment of intramedullary spinal cord tumors. Methods: A retrospective analysis of 17 patients with intramedullary spinal cord cancer clinical features, diagnostic criteria and surgical methods and efficacy. Results: 8 cases were diagnosed as ependymoma, 5 astrocytoma, 2 cavernous hemangioma, 2 lipoma, 16 cases were treated by posterior approach, 1 case by rib-transverse approach, and total tumor resection 12 cases, subtotal resection in 2 cases, partial resection in 3 cases, postoperative symptoms and signs improved in 9 cases, stable in 5 cases, 2 cases of exacerbations, 1 case of death. Conclusions: Spinal intramedullary tumors occur in adults, more common in men, longer duration and more common in the cervical segment, MRI diagnosis of spinal cord intramedullary tumors with high specificity. Surgical methods vary with the type of tumor; malignant and incomplete resection of tumor radiotherapy good effect.