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目的:探讨颈椎管内肿瘤的早期诊断及显微手术对外科治疗的临床意义。方法:对1985~2001年收治的74例颈椎管内肿瘤患者的诊断及治疗进行回顾性分析。术前均行X线摄片,12例行椎管碘油造影,17例行CT检查,45例行MRI检查。均采用显微外科手术治疗。结果:颈椎管内肿瘤早期采用椎管碘油造影、CT检查均存在不同程度的漏诊或误诊,采用MRI检查者均能确定肿瘤的部位和性质。74例中行肿瘤全切除58例(78.4%),次全切除5例,大部分切除11例。术后神经功能改善61例,病情加重或无改善10例,死亡3例。结论:MRI对颈椎管内肿瘤有较高的定位、定性诊断价值,对制定手术方案也有指导意义。不同部位和病理类型的颈椎管内肿瘤采用显微手术切除应遵循不同的原则和方法,显微手术具有解剖层次分明、肿瘤切除完全、对脊髓干扰小等优点。
Objective: To investigate the clinical significance of early diagnosis of cervical spinal tumor and microsurgery for surgical treatment. Methods: The diagnosis and treatment of 74 patients with cervical spinal canal admitted from 1985 to 2001 were retrospectively analyzed. Preoperative X-ray, 12 cases of spinal iodine oil imaging, 17 cases of CT, 45 cases of MRI. Microsurgery was used. Results: Cervical spinal canal tumors were treated with spinal lipiodol angiography in the early stage. CT examination revealed misdiagnosis or misdiagnosis to some extent. The location and nature of the tumor can be determined by MRI. In the 74 cases, 58 cases (78.4%) underwent total resection of tumors, subtotal resection in 5 cases and resection in 11 cases. Postoperative neurological improvement in 61 cases, aggravating or no improvement in 10 cases, 3 died. Conclusion: MRI has a higher localization and diagnostic value for cervical spinal tumors, which is also instructive for the development of surgical plans. Different parts and pathological types of cervical spinal tumors using microsurgical resection should follow different principles and methods, microsurgery has a clear anatomy, complete tumor resection, the advantages of small interference to the spinal cord.