CAJ | 학술논문

目的探讨有脊髓压迫症状的婴幼儿神经母细胞瘤(NB)治疗要点.方法收集2000年2月至2007年5月上海交通大学医学院附属新华医院10例2岁以下有脊髓压迫症状的NB的患儿,其中男7例,女3例,6个月内5例,6个月～1岁3例,1～2岁2例.结果本组中9例先行椎板切除减压、硬脊膜外肿瘤切除,1例外院活检后病理明确NB,化疗二个疗程后出现脊髓压迫再行椎管手术.病理报告未分化型1例,分化差型7例,分化型2例.10例有9例神经外科术后家长放弃治疗,1例行化疗.获随访8例中死亡1例,存活的7例中,5例原发部位NB自然消退,1例行原发部位肿瘤切除,病理证实转化为神经节细胞瘤.1例椎管术后行化疗,原发部位NB完全消失.结论本组中椎管术后原发部位NB自然消退比重极高,除年龄因素外是否与椎管手术有关值得关注.在自然消退机制未阐明前,1岁以内哑铃形NB神经外科术后应积极干预.
목적 탐토유척수압박증상적영유인신경모세포류(NB)치료요점.방법 수집2000년2월지2007년5월상해교통대학의학원부속신화의원10례2세이하유척수압박증상적NB적환인,기중남7례,녀3례,6개월내5례,6개월～1세3례,1～2세2례.결과 본조중9례선행추판절제감압、경척막외종류절제,1예외원활검후병리명학NB,화료이개료정후출현척수압박재행추관수술.병리보고미분화형1례,분화차형7례,분화형2례.10례유9례신경외과술후가장방기치료,1례행화료.획수방8례중사망1례,존활적7례중,5례원발부위NB자연소퇴,1례행원발부위종류절제,병리증실전화위신경절세포류.1례추관술후행화료,원발부위NB완전소실.결론 본조중추관술후원발부위NB자연소퇴비중겁고,제년령인소외시부여추관수술유관치득관주.재자연소퇴궤제미천명전,1세이내아령형NB신경외과술후응적겁간예.
Objective To investigate the role of neurosurgical decompression in the treatment of neuroblastoma with intraspinal extensions.Methods Between February 2000 and May 2007,10 patients (7 male and 3 female,5 age less than 6 months old,3 between 6 months and 12 months old,2 between 1 and 2 years old) were diagnosed as intraspinal neuroblastoma and underwent surgical resection at Xin-Hua hospital in Shanghai.Results Surgical decompression with laminectomy and removal of tumor were performed in 9 patients.One case was diagnosed in other hospital by biopsy,had treated with two courses of chemotherapy,and then ccme to our hospital for neurosurgical decompression.Nine cases were abandoned treatment after surgery,only one followed the chemotherapy.Seven cases were alive in eight followed-up cases.Among them,tumor regression happened in 5 cases,spontaneous maturation in 1 case,and total disappearance after chemotherapy in 1 case.Conclusions The prognosis of patients with intraspinal neuroblastoma is excellent even without radical operation.These findings suggest the possibility that neurosurgical decompression is associated with favorable prognosis.Based on present knowledge,surgical decompression combined with chemotherapy maybe adequate for patients less than 6 months old with intraspinal neuroblastoma.