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目的分析以恶性脊髓压迫症为首发症状的肿瘤患者临床表现、诊断及治疗效果。方法回顾性分析33例以恶性脊髓压迫症为起始症状患者的临床资料,确定诊断后给予手术、放射治疗和对症治疗。结果 6例行手术治疗,术后5例患者肢体运动、感觉障碍好转,截瘫1例手术前、后各项功能无改善;18例行放射治疗,放疗后疼痛缓解16例、感觉障碍改善8例、运动障碍改善6例、排尿及排便障碍改善7例,截瘫1例放疗后运动及感觉障碍无变化;9例行对症支持治疗,逐渐出现截瘫及大小便障碍等症状。结论恶性脊髓压迫症具有典型临床表现,确诊依赖于X线平片,CT,MRI等影像学检查;放疗及手术联合糖皮质激素治疗恶性脊髓压迫症有效。
Objective To analyze the clinical manifestations, diagnosis and treatment of patients with malignant spinal cord compression disease as the first symptom. Methods A retrospective analysis of 33 patients with malignant spinal cord compression as the initial symptoms of clinical data to determine the diagnosis given surgery, radiation therapy and symptomatic treatment. Results Six patients underwent surgical treatment. After the operation, limb movement and sensory dysfunction were improved in 5 patients. There was no improvement in the function of one patient with paraplegia before and after operation. In 18 patients underwent radiotherapy, pain relief was relieved after radiotherapy in 16 patients and sensory disturbance was improved in 8 patients , Dyskinesia improved in 6 cases, urination and defecation improved in 7 cases, paraplegia after radiotherapy and no change in motor and sensory disturbances; 9 cases of symptomatic and supportive treatment, and gradually paraplegia and urine and other symptoms. Conclusion Malignant spinal cord compression has typical clinical manifestations. The diagnosis depends on X-ray, CT, MRI and other radiological examinations. Radiotherapy and operation combined with glucocorticoid are effective in treating malignant spinal cord compression.