[1]苏 保,唐 可,权正学,等.改良后路全脊椎整块切除术治疗胸腰椎肿瘤的疗效[J].医学信息,2020,33(17):112-116.[doi:10.3969/j.issn.1006-1959.2020.17.033]
　SU Bao,TANG Ke,QUAN Zheng-xue,et al.Treatment of Thoracolumbar Tumors by Modified Posterior Total Spinal Block Resection[J].Medical Information,2020,33(17):112-116.[doi:10.3969/j.issn.1006-1959.2020.17.033]
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改良后路全脊椎整块切除术治疗胸腰椎肿瘤的疗效()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年17期
页码:
112-116
栏目:
临床研究
出版日期:
2020-09-01

文章信息/Info

Title:
Treatment of Thoracolumbar Tumors by Modified Posterior Total Spinal Block Resection
文章编号:
1006-1959（2020）17-0112-05
作者:
苏 保; 唐 可; 权正学; 等
（1.重庆医科大学附属第一医院骨科，重庆 400016；2.重庆医科大学附属第三医院骨与创伤中心，重庆 400016）
Author(s):
SU Bao; TANG Ke; QUAN Zheng-xue; et al
(1.Department of Orthopedics,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;2.Bone and Trauma Center,the Third Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
关键词:
胸腰椎肿瘤; 改良全脊椎整块切除; 后路; 手术技巧
Keywords:
thoracolumbar tumors; Modified whole spine resection; Posterior approach; Surgical techniques
分类号:
R738.1
DOI:
10.3969/j.issn.1006-1959.2020.17.033
文献标志码:
A
摘要:
目的 探讨改良后路全脊椎整块切除术治疗胸腰椎肿瘤的临床疗效。方法 回顾性分析2014年1月~2017年7月我科19例诊断为原发或转移单发胸腰椎肿瘤患者的临床资料，均行改良后路全脊椎整块切除术，分析手术情况以及术前、术后1周、术后6个月患者局部疼痛和神经功能恢复情况。结果 所有患者均行后路全脊椎整块切除术手术1期完整切除肿瘤，术中无脊髓、神经根意外损伤。术中出血量300~2200 ml，平均术中出血量（830.53±430.36）ml；手术时间195~374 min，平均手术时间（290.42±44.64）min；术中输血量0~800 ml，平均术中输血量（342.11±296.86）ml。术前VAS评分（5.68±1.57）分，术后7 d VAS评分（1.79±0.86）分，术后6月VAS评分（1.11±0.46）分，术前与术后VAS评分比较，差异有统计学意义（P＜0.05）。术后随访6个月，1例ASIA B级神经功能患者术后恢复为D级，1例ASIA C级神经功能患者术后恢复为D级，5例ASIA D级神经功能患者术后恢复为E级，其余12例ASIA E级神经功能患者术后仍为E级。结论 对于原发或转移单发胸腰椎肿瘤患者，改良全脊椎整块切除术是治疗胸腰椎单发肿瘤可靠和有效的方式，术后患者疼痛缓解明显，出血量较少。
Abstract:
Objective To investigate the clinical effect of modified posterior total spinal resection for thoracolumbar tumors.Methods The clinical data of 19 cases diagnosed as primary or metastatic thoracolumbar tumors in our department from January 2014~July 2017 were retrospectively analyzed,all underwent modified posterior total spinal resection,the operation and the recovery of local pain and nerve function were analyzed before,1 week after operation and 6 months after operation.Results All patients underwent posterior total spinal surgery, stage 1 complete resection,there was no accidental injury of spinal cord and nerve root during operation. intraoperative bleeding 300~2200 ml,mean intraoperative bleeding (830.53±430.36) ml;operation time 195~374 min, mean operating time (290.42±44.64) min;intraoperative blood transfusion 0~,800 ml,mean intraoperative blood transfusion (342.11±296.86) ml. Preoperative VAS score (5.68±1.57), 7 d VAS after surgery (1.79±0.86),six months after surgery VAS score (1.11±0.46),comparison of preoperative and postoperative VAS scores,the difference was statistically significant (P<0.05).6 months after surgery,1 patient with grade ASIA B neurological function recovered to grade D,1 patient with grade ASIA C neurological function recovered to grade D, the 5 patients with grade ASIA D neurological function recovered to grade E,the remaining 12 patients with grade ASIA E neurological function were still grade E after operation.Conclusion For patients with primary or metastatic single thoracolumbar tumors, modified whole spine resection was a reliable and effective method for treating single thoracic and lumbar tumors,postoperative pain relief was obvious,the amount of bleeding was less.

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更新日期/Last Update: 1900-01-01