CAJ | 학술논문

目的:探讨胸腔镜联合半椎板切除治疗胸椎管哑铃型肿瘤的临床疗效.方法:2007年6月至2009年1月收治6例胸椎管哑铃型肿瘤患者,男4例,女2例.年龄25～63岁,平均35.5岁,均采用胸腔镜联合后正中入路半椎板开窗切除病变.术后随访观察临床疗效并行MRI检查,观察肿瘤切除情况及对脊柱稳定性的影响.结果:6例患者均手术全切肿瘤,无1例死亡.手术时间3～5h,平均3.8h;术中失血量80～300ml,平均130ml.伤口均一期愈合,无脑脊液漏及切口、胸腔感染发生.病理榆查结果示神经鞘瘤5例,脊膜瘤1例.术后患者症状均有不同程度缓解,5例有胸背疼痛患者疼痛消失,3例术前有脊髓压迫症状者,其中2例完全恢复,1例双下肢瘫痪者术后肌力恢复至4+级.复查MRI均未见肿瘤残留.随访6个月～2年,所有患者均未见肿瘤复发及脊柱不稳定.结论:应用胸腔镜联合半椎板开窗切除胸椎管哑铃型肿瘤有较好的临床疗效.
목적:탐토흉강경연합반추판절제치료흉추관아령형종류적림상료효.방법:2007년6월지2009년1월수치6례흉추관아령형종류환자,남4례,녀2례.년령25～63세,평균35.5세,균채용흉강경연합후정중입로반추판개창절제병변.술후수방관찰림상료효병행MRI검사,관찰종류절제정황급대척주은정성적영향.결과:6례환자균수술전절종류,무1례사망.수술시간3～5h,평균3.8h;술중실혈량80～300ml,평균130ml.상구균일기유합,무뇌척액루급절구、흉강감염발생.병리유사결과시신경초류5례,척막류1례.술후환자증상균유불동정도완해,5례유흉배동통환자동통소실,3례술전유척수압박증상자,기중2례완전회복,1례쌍하지탄탄자술후기력회복지4+급.복사MRI균미견종류잔류.수방6개월～2년,소유환자균미견종류복발급척주불은정.결론:응용흉강경연합반추판개창절제흉추관아령형종류유교호적림상료효.
Objective:To investigate the clinical efficacy of combined thoracoscopic and semi-laminectomy for the treatment of thoracic spinal canal dumbbell-shaped tumor.Method :Six patients complicated with thoracic spinal canal dumbbell-shaped tumor experienced combined thoracoscopie and semi-laminectomy between July 2007 and January 2009.There were 4 males and 2 females with an average age of 35.5 years(range,25 to 63 years).Thc clinical outcome was evaluated and the status of tumor excision as well as effect on spine stability were also assessed by MRI during follow up.Result:Complete tumor excision was performed in all cases with no death noted.The average surgical time was 3.8h (range,3 to 5h).The average blood loss was 130ml(range, 80 to 300ml).All skin excision healed well,with no case of eerebrospinal fluid leakage and chest cavity in-fection.Parthenogenesis included neurilemmoma (5 cases) and meningioma (1 case).All patients had clinical symptoms improved.Thoraeodorsal pain disappeared in all cases,2 of 3 cases with spinal cord compression preoperatively had neurofunction improved completely,while another case had muscle strength of lower limbs recovered to level 4~+.No tumor recurrence and spine instability was noted in 2-years follow-up.Conclusion: Combined thoracoscopic and semi-laminectomy indicated for thoracic spinal canal dumbbell-shaped tumor is feasible and safety.