Martynov Iu S, Orlov V K, Iarikov D E, Andreeva N E, Sonina E I, Sokov E L, Malkova E V, Norzdriukhina N V, Shuvakhina N A
Zh Nevrol Psikhiatr Im S S Korsakova. 1998;98(11):9-13.
Myelomic spinal cord damage may be a result of both its compression and vascular disorders (squeezing of an artery, disorders of venous outflow). Diagnosis is based on evaluation of the following signs: normochromic anemia; increase of ESR, total protein and calcium levels; discovery of M-gradient in protein fractions of gamma-zone; multiple regions of destruction in spondylogramme. In doubtful cases magneto-resonance and computer tomography were the most informative. Highly effective was therapy with intensive chemoprogramme including either a range of preparations (alkeran, BGNU, cyclophosphan, adriblastina, prednisolon) or a combination of polychemotherapy with irradiation. The operation was indicated in both insufficiency of conservative therapy and increasing of the symptoms of the damage.
骨髓瘤性脊髓损伤可能是其受压和血管疾病(动脉受压、静脉回流障碍)共同作用的结果。诊断基于对以下体征的评估:正色素性贫血;血沉、总蛋白和钙水平升高;γ区蛋白组分中出现M梯度;脊柱X线片上有多个破坏区域。在疑难病例中,磁共振成像和计算机断层扫描提供的信息最多。采用包括一系列制剂(马利兰、卡氮芥、环磷酰胺、阿霉素、泼尼松龙)的强化化疗方案或多药化疗与放疗联合的治疗方法效果显著。在保守治疗无效以及损伤症状加重的情况下均需进行手术治疗。