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[脊柱良性肿瘤的随访研究]

[Follow-up study of benign tumors of the spine].

作者信息

Schöche J, Hohrein D

出版信息

Zentralbl Neurochir. 1980;41(3):223-30.

PMID:7467985
Abstract

A report is given on long-term results after the removal of spinal mengiomas and neurinomas. A total of 150 patients with meningiomas and 80 patients with spinal neurinomas were operated on within a period of 25 years at the Neurosurgical Clinic in the Division Medicine of the Karl-Marx-University Leipzig. The primary results of the operations are secertained by a comparison of the preand portoperative ability to walk. Improvements were found in one third of all patients after meningioma operations and in more than ten per cent of the patients after removal of a neurinoma. The long-term rests were ascertained by means of questioning all patients that could be contracted after 2 to 25 years, sending them a questionaire in the form of a reply card. The number of patients who had become able to walk had doubles as compared with the condition before the operation: 56 per cent of all patients after meningioma operations and 64 per cent of all patients after removal of a spinal neurinoma. The long-term results have not been mainly influenced by the age of the patients and by the duration of the anamnesis. The greatest threat for patients with benign spinal tumours are the misjudging of the disease and a certain loss of time when paralysis was threatening. The prognosis in operations for relapses was considerably worse. So radical surgery in the first intervention must be attached the greatest importance. A tendency to infiltrations in case of meningiomas, especially in juvenile patients, and the overlooking of the smallest parts of extradural tumours in case of neuromas are frequent causes of the development of relapses and should be taken into account when carrying out the first ingervention.

摘要

本文报告了脊髓脑膜瘤和神经鞘瘤切除术后的长期结果。在25年的时间里,莱比锡卡尔·马克思大学医学院神经外科诊所共对150例脑膜瘤患者和80例脊髓神经鞘瘤患者进行了手术。通过比较术前和术后的行走能力来确定手术的初步结果。脑膜瘤手术后,三分之一的患者有改善;神经鞘瘤切除术后,超过10%的患者有改善。通过询问所有在2至25年后能联系上的患者,并以回复卡的形式向他们发送问卷来确定长期结果。与手术前相比,能够行走的患者数量增加了一倍:脑膜瘤手术后所有患者的56%,脊髓神经鞘瘤切除术后所有患者的64%。长期结果主要不受患者年龄和病史时长的影响。对于患有良性脊柱肿瘤的患者来说,最大的威胁是对疾病的误诊以及在出现瘫痪威胁时一定程度的时间延误。复发性手术的预后要差得多。因此,首次干预时必须极其重视彻底的手术。脑膜瘤尤其是青少年患者中出现浸润的倾向,以及神经鞘瘤病例中硬膜外肿瘤最小部分的遗漏,是复发的常见原因,在进行首次干预时应予以考虑。

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