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目的探讨小儿后纵隔椎管肿瘤的分型和手术方式,以提高对该病的认识及疗效。方法男12例,女11例,年龄5个月至6岁,平均(2.3±1.6)岁。术前均摄胸部X线光片、CT或MRI并进行分型:Ⅰ型5例;Ⅱ型6例;Ⅲ型11例;Ⅳ型1例;椎管内的肿瘤均位于硬膜外;术前依据分型选择适当的治疗方案。结果23例中良性11例,其中畸胎瘤1例、肠源性囊肿3例、神经节细胞瘤7例;恶性12例,其中恶性神经鞘瘤1例、节细胞性神经母细胞瘤1例、神经母细胞瘤10例。16例行椎管及纵隔同期手术,7例进行了分期手术。随访1-8年,17例有神经症状中的13例均不同程度改善或恢复正常。结论影像学检查结合临床表现是儿童后纵隔椎管肿瘤诊断、分型和确定手术方案的主要方法,神经外科和胸外科同期手术是治疗小儿后纵隔椎管肿瘤安全有效的方式。
Objective To explore the pediatric posterior mediastinal spinal tumor classification and surgical methods to enhance awareness of the disease and efficacy. Methods 12 males and 11 females, aged 5 months to 6 years, with an average of (2.3 ± 1.6) years. Preoperative chest X-ray film, CT or MRI and classification: Ⅰ type 5 cases; Ⅱ type 6 cases; Ⅲ type 11 cases; Ⅳ type 1 cases; spinal tumors are located in the epidural; surgery According to the type of choice before the appropriate treatment. Results Of the 23 cases, 11 were benign, including 1 teratoma, 3 intestinal-derived cyst, 7 ganglioneuroma, 12 malignant tumors including 1 malignant schwannoma and 1 ganglioneuroblastoma , Neuroblastoma in 10 cases. Sixteen patients underwent simultaneous surgery of the canal and mediastinum, and seven patients underwent staging surgery. During the follow-up of 1-8 years, 13 of the 17 patients with neurological symptoms improved or returned to normal to some extent. Conclusions Radiographic examination combined with clinical manifestations is the main method of diagnosis, classification and surgical treatment of posterior mediastinal spinal tumors in children. Neurosurgical and thoracic surgical procedures are safe and effective for the treatment of posterior mediastinal spinal tumors in children.