脊髓胶质瘤的显微外科治疗

               作者：洪国良， 杨新宇， 岳树源， 杨树源

【摘要】  目的 探讨脊髓胶质瘤的显微手术效果和预后。 方法 回顾性分析113例脊髓胶质瘤的手术治疗经验。本组术前McCormick分级Ⅰ级22例，Ⅱ级46例，Ⅲ级31例，Ⅳ级12例，Ⅴ级2例。均行显微手术切除肿瘤，术后对未能全切除的47例均行放射治疗。 结果 脊髓胶质瘤全切除66 例，次全切除25 例，部分切除或活检22 例。对105例行6~186个月随访，McCormick分级改善48 例，无变化46 例，加重8例，死亡3 例。 结论 利用显微外科技术切除脊髓胶质瘤，大多数病例可以做到次全切除或全切除，预后满意；不能全切除者可辅以放射治疗。

【关键词】  脊髓肿瘤 神经胶质瘤 显微外科手术

    Microsurgery for spinal cord gliomas

       Abstract:  Objective  To explore the microsurgical efficacy and prognosis of spinal gliomas.  Methods  The surgical experience with resection of spinal cord glioma in 113 patients was retrospectively analyzed. Preoperative McCormick grade was Ⅰ in 22 cases, Ⅱ in 46, Ⅲ in 31, Ⅳ in 12, and Ⅴ  in 2. All the patients were operated on by microsurgical techniques. Postoperative radiological treatment was performed in 47 patients who did not receive total resection of the tumor.  Results  Total tumor resection was achieved in 66 cases, subtotal in 25, and partial or biopsy in 22. One hundred and five patients were followed up from 6 to186 months respectively. Among them, McCormick grade was improved in 48 cases, unchanged in 46, deteriorated in 8, and dead occurred in 3.  Conclusion  Using microsurgical techniques, total or subtotal tumor remove can be achieved with a satisfactory prognosis in a majority of spinal cord glioma

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