国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2012年
14期
2044-2046
,共3页
恶性外周神经鞘膜瘤%神经纤维瘤%临床分析
噁性外週神經鞘膜瘤%神經纖維瘤%臨床分析
악성외주신경초막류%신경섬유류%림상분석
Malignant peripheral nerve sheath tumor%Neurofibroma%Clinical analysis
[目的]探讨分析恶性外周神经鞘膜瘤发病特点和临床症状特点.[方法]将我院2006年2月至2011年2月神经外科15例头颈部恶性外周神经鞘膜瘤患者为观察组,将同期18例良性头颈部神经纤维瘤患者为对照组.对照组患者均行手术治疗,观察组患者根据病情特点以及一般情况选择姑息手术+化疗或姑息手术+放疗.比较两组间患者肿瘤病灶组织形态学特点、早期临床症状、其他肿瘤合并情况以及生存率.[结果]观察组患者肿瘤病灶呈弥散性生长14例(93.33％),平均肿瘤大小(3.6±0.8)cm×(2.0±0.5)cm,病灶陈旧性出血10例(66.57％)明显高于对照组患者肿瘤病灶呈弥散性生长6例(33.33％),平均肿瘤大小(1.7±0.5) cm×(0.9±0.3) cm,病灶陈旧性出血2例(11.11％),差异有显著性(P＜0.05).(2)观察组患者早期临床症状疼痛15例(100％),运动障碍4例(26.67％),感觉障碍6例(40％)明显高于对照组患者早期临床症状疼痛7例(38.89％),运动障碍2例(11.11％),感觉障碍3例(16.67％),差异有显著性(p＜0.05).(3)观察组患者合并听神经瘤6例、脊膜瘤4例、胶质细胞瘤2例,合并率为80％,1年生存率73.33％,5年生存率为6.67％明显异于对照组患者合并听神经瘤1例、脊膜瘤1例、胶质细胞瘤0例,合并率为11.11％,1年生存率100％,5年生存率为97.56％,差异有显著性(P＜0.05).[结论]恶性外周神经鞘膜瘤较良性神经纤维瘤起病急,早期临床症状显著,病情发展复杂,治疗愈后不良,因此临床诊断治疗应给予高度重视.
[目的]探討分析噁性外週神經鞘膜瘤髮病特點和臨床癥狀特點.[方法]將我院2006年2月至2011年2月神經外科15例頭頸部噁性外週神經鞘膜瘤患者為觀察組,將同期18例良性頭頸部神經纖維瘤患者為對照組.對照組患者均行手術治療,觀察組患者根據病情特點以及一般情況選擇姑息手術+化療或姑息手術+放療.比較兩組間患者腫瘤病竈組織形態學特點、早期臨床癥狀、其他腫瘤閤併情況以及生存率.[結果]觀察組患者腫瘤病竈呈瀰散性生長14例(93.33％),平均腫瘤大小(3.6±0.8)cm×(2.0±0.5)cm,病竈陳舊性齣血10例(66.57％)明顯高于對照組患者腫瘤病竈呈瀰散性生長6例(33.33％),平均腫瘤大小(1.7±0.5) cm×(0.9±0.3) cm,病竈陳舊性齣血2例(11.11％),差異有顯著性(P＜0.05).(2)觀察組患者早期臨床癥狀疼痛15例(100％),運動障礙4例(26.67％),感覺障礙6例(40％)明顯高于對照組患者早期臨床癥狀疼痛7例(38.89％),運動障礙2例(11.11％),感覺障礙3例(16.67％),差異有顯著性(p＜0.05).(3)觀察組患者閤併聽神經瘤6例、脊膜瘤4例、膠質細胞瘤2例,閤併率為80％,1年生存率73.33％,5年生存率為6.67％明顯異于對照組患者閤併聽神經瘤1例、脊膜瘤1例、膠質細胞瘤0例,閤併率為11.11％,1年生存率100％,5年生存率為97.56％,差異有顯著性(P＜0.05).[結論]噁性外週神經鞘膜瘤較良性神經纖維瘤起病急,早期臨床癥狀顯著,病情髮展複雜,治療愈後不良,因此臨床診斷治療應給予高度重視.
[목적]탐토분석악성외주신경초막류발병특점화림상증상특점.[방법]장아원2006년2월지2011년2월신경외과15례두경부악성외주신경초막류환자위관찰조,장동기18례량성두경부신경섬유류환자위대조조.대조조환자균행수술치료,관찰조환자근거병정특점이급일반정황선택고식수술+화료혹고식수술+방료.비교량조간환자종류병조조직형태학특점、조기림상증상、기타종류합병정황이급생존솔.[결과]관찰조환자종류병조정미산성생장14례(93.33％),평균종류대소(3.6±0.8)cm×(2.0±0.5)cm,병조진구성출혈10례(66.57％)명현고우대조조환자종류병조정미산성생장6례(33.33％),평균종류대소(1.7±0.5) cm×(0.9±0.3) cm,병조진구성출혈2례(11.11％),차이유현저성(P＜0.05).(2)관찰조환자조기림상증상동통15례(100％),운동장애4례(26.67％),감각장애6례(40％)명현고우대조조환자조기림상증상동통7례(38.89％),운동장애2례(11.11％),감각장애3례(16.67％),차이유현저성(p＜0.05).(3)관찰조환자합병은신경류6례、척막류4례、효질세포류2례,합병솔위80％,1년생존솔73.33％,5년생존솔위6.67％명현이우대조조환자합병은신경류1례、척막류1례、효질세포류0례,합병솔위11.11％,1년생존솔100％,5년생존솔위97.56％,차이유현저성(P＜0.05).[결론]악성외주신경초막류교량성신경섬유류기병급,조기림상증상현저,병정발전복잡,치료유후불량,인차림상진단치료응급여고도중시.
[Objective]To explore and analyze the biological characteristics and clinical effect of malignant peripheral nerve sheath tumor.[Methods]15 patients with head and neck malignant peripheral nerve sheath tumor in our department were chosen as observation group.15 patients with head and neck benign neurofibroma were.selected aa control group.Observation group underwent palliative operation+ chemotherapy or radiation treatment while control group underwent corresponding operations.The histopathology,early clinical symptom and survival rate were compared in two groups.[Results]①In observation group,the histopathology such as diffuse growth (14 cases,93.33％),average tumor size (3.6± 0.8cm × 2.0 ± 0.5) and remote hemorrhage (10 cases,66.57％) were higher than those in control group,with statistical significant differences (P＜ 0.05),the observation group was worse than control group.②The early clinical symptoms such as acute pain,dyskinesia and dysesthesia in two groups had statistical significant differences (P＜ 0.05),the observation group was much worse than control group.③There were 6 patients having acoustic neurinoma,4 patients had meningioma and 2 patients had gliocytoma in observation group,and the 1 year survival rate was 73.33/ and 5 year survival rate was 6.67％.While the 1 year survival rate and 5 year survival rate were 100％ and 97.56％ respectively in control group.The differences between two groups was obvious and had statistical significance (P ＜ 0.05).[Conclusion]The malignant peripheral nerve sheath tumor has early obvious clinical symptoms,complicated states of illness,poor prognosis,so enough attention should be paid to its clinical diagnosis.
