论文部分内容阅读
目的 :探讨胸椎椎管内外肿瘤分型及手术方法 ,以提高手术疗效。方法 :分析 13例胸椎椎管内外肿瘤 (神经纤维瘤 6例 ,恶性神经鞘瘤、脊膜瘤、骨软骨瘤、脂肪血管瘤、海绵状血管瘤、肝转移癌、肾转移癌各 1例 )患者的临床特征和影像学资料 ,根据肿瘤主体部位和涉及范围分为Ⅰ、Ⅱ、Ⅲ、Ⅳ型 ,Ⅱ、Ⅲ型采用经胸联合后正中入路手术切除 ,Ⅰ、Ⅳ型采用后正中入路手术切除。结果 :Ⅰ型 3例 ,Ⅱ型 1例 ,Ⅲ型 6例 ,Ⅳ型 3例 ;12例获肉眼下全切 ,1例恶性神经鞘瘤因胸腔内广泛浸润次全切除。患者症状均不同程度改善。结论 :将胸椎椎管内外肿瘤适当分型 ,选择相应手术方式 ,能提高肿瘤的全切除率 ,增加手术的安全性。
Objective: To explore the thoracic internal and external tumor classification and surgical methods to improve the efficacy of surgery. Methods: Thirteen cases of thoracic internal and external tumors were analyzed (6 cases of neurofibromas, malignant schwannoma, meningioma, osteochondroma, lipangioma, cavernous hemangioma, liver metastases, and renal metastases in 1 case). The patient’s clinical features and imaging data were classified into type I, II, III, and IV according to the main part of the tumor and the involved area. Types II and III were treated with a transthoracic approach and a median approach. Surgical resection was performed after type I and type IV. Surgical resection. Results: There were 3 cases of type I, 1 case of type II, 6 cases of type III and 3 cases of type IV. 12 cases were totally cut under the naked eye, and 1 case of malignant schwannoma was subtotally resected through extensive intrathoracic infiltration. The patient’s symptoms improved to varying degrees. Conclusion : Properly classifying the thoracic internal and external tumors and selecting the appropriate surgical methods can increase the total resection rate and increase the safety of the operation.