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目的:报告31例脊髓髓内肿瘤的显微外科治疗结果,总结髓内肿瘤的显微外科治疗经验。方法:回顾性分析31例脊髓髓内肿瘤的临床表现、影像学特征、手术方法、手术技巧、手术结果,讨论手术时机的选择、术中注意事项及围手术期处理。结果:31例病人中星形细胞瘤12例,室管膜瘤10例,海绵状血管瘤6例,脂肪瘤1例,神经纤维瘤1例,室管膜囊肿1例。显微手术下肿瘤全部切除26例（84％）,次全切除3例（10％）,部分切除2例（6％）。术后死亡1例。随访19例,症状改善13例,不变3例,加重3例。结论:显微手术切除是髓内肿瘤唯一有效的治疗手段。强调室管膜瘤应全切除,星形细胞瘤追求全切除并尽量保持脊髓功能,脂肪瘤也可做到全切。
Objective: To report the results of microsurgical treatment of 31 cases of spinal intramedullary tumors and summarize the experience of microsurgical treatment of intramedullary tumors. Methods: The clinical manifestations, imaging features, surgical methods, surgical techniques, surgical outcomes, the choice of timing of surgery, intraoperative considerations and perioperative management of 31 patients with spinal intramedullary tumors were retrospectively analyzed. Results: Among the 31 patients, there were 12 cases of astrocytoma, 10 cases of ependymoma, 6 cases of cavernous hemangioma, 1 case of lipoma, 1 case of neurofibroma and 1 case of ependymal cyst. Tumor resection in microsurgical resection of 26 cases (84%), subtotal resection in 3 cases (10%), partial resection in 2 cases (6%). One patient died after operation. Follow up of 19 cases, 13 cases improved, unchanged in 3 cases, aggravated in 3 cases. Conclusion: Microsurgical resection is the only effective treatment for intramedullary tumors. Emphasis on ependymoma should be fully resected, astrocytoma pursuit of total resection and try to maintain spinal cord function, lipoma can also be cut.