Management of intramedullary spinal cord tumours: review of 68 patients.
Management of intramedullary spinal cord tumours: review of 68 patients.
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作者：
M. Chandy;S. Babu
本文讨论了自1990年1月起六年内在韦洛雷接受手术治疗的68例脊髓髓内肿瘤患者。根治性切除41例，部分切除11例，活检14例。建议对部分切除或活检的患者术后进行放射治疗。无术后死亡。2例患者发生伤口感染，1例发生术后脑积水。术后4 - 8周的临床评估显示，68例患者中有25例改善，29例保持不变，14例功能障碍恶化。然而，术后即刻评估并不那么令人鼓舞。使用功能评分系统和Karnofsky评分对这些患者进行评价。随访时间2周至64个月，平均14.6个月。根治性切除的指标是良好的肿瘤-脊髓界面，位于颅侧的肿瘤，存在脊髓压迫和室管膜瘤的组织学。2例患者肿瘤复发。
68 consecutive patients admitted with intramedullary spinal cord tumours and operated at Vellore during a six year period from January 1990 are discussed. 41 tumours were radically resected, 11 partially excised while 14 had only a biopsy. Radiation therapy was advised post operatively to those patients for whom a partial excision or biopsy was done. There was no postoperative mortality. Two patients developed wound infection and one developed postoperative hydrocephalus. Postoperative clinical assessment between four to eight weeks after surgery showed that 25 out of 68 patients improved, 29 remained unchanged, while 14 had worsening of deficits. Immediate post operative assessment, however, was less encouraging. Evaluation of these patients was done using a functional scoring system and Karnofsky rating. The follow up period ranged from 2 weeks to 64 months after discharge from hospital with a mean of 14.6 months. The indicators of radical excision were good tumour-cord interface, cranially located tumours, presence of syringomyelia and histology of ependymoma. Two patients had recurrence of tumour.