单后路切除突入胸腔内的巨大椎管哑铃状肿瘤-外科学(神经外科)专业论文.docx

重庆医科 重庆医科大学硕士研究生学位论文 万方数据 万方数据 英汉缩略语名词对照 英文缩写 MRI 英文全称 Magnetic Resonance Imaging 中文全称 核磁共振成像 cm CT centimeter Computed Tomography 厘米 电子计算机体层扫描 CTA T Computed Tomography Angiography Thoracic CT 血管成像 胸椎 L S Lumbar Sacral 腰椎 骶椎 1 单后路切除突入胸腔内的巨大椎管哑铃状肿瘤 摘 要 【目的】 探讨经单后路切除突入胸腔内的巨大椎管哑铃状肿瘤的手术方法 及效果。 【方法】 回顾性分析我院神经外科2012年2月至2014年2月间采用单一后正 中直切口入路行手术切除的12例突入胸腔内的巨大椎管哑铃状肿瘤病 例，与文献中采用胸腔镜联合后正中入路以及后正中联合椎旁入路行 手术切除的类似病例的手术情况进行对比。 【结果】 3组全部病例均完成了肿瘤全切除。本组1例同时行脊柱内固定术， 手术时间120-315min，平均195min，术中出血量50-300ml，平均205ml； 经胸腔镜联合后正中入路组手术时间320-340分钟，平均328分钟，出 血量450-500ml，平均483ml；经后正中联合椎旁切口入路组全部患者 同时行脊柱内固定术，手术时间185-420分钟，平均313分钟，术中出 血量71-1830ml，平均657ml。 【结论】 突入胸腔内的巨大椎管哑铃状肿瘤多数可经单后路正中直切口进 入而无需开胸，亦无需辅助入路及肋骨切除，即可达到肿瘤全切除， 2 该手术方式创伤小、手术时间短、出血量少。 【关键词】哑铃状肿瘤，椎管肿瘤，手术入路 3 PURELY POSTERIOR APPROACH RESECTION FOR LARGE SPINAL DUMBBELL-SHAPED TUMORS EXTEND INTO THE THORACIC CAVITY ABSTRACT Objective To study the surgical technique and to evaluate the outcome of purely posterior resection for large spinal dumbbell-shaped tumors that extend into the thoracic cavity. Methods: We retrospectively analyzed 12 cases of large dumbbell-shaped tumors that extend into the thoracic cavity our department admitted between February 2012 and February 2014，all cases were operated through a purely posterior approach, operation data were compared with similar cases that through thoracoscopic combined with posterior approach and posterior combined with paravertebral approach in literatures Results All patients in 3 groups were achieved total resection. one patient in our group required spinal internal fixation, operation time was 120-315minutes,mean 195 minutes, blood loss was 50-300ml ， mean 4 205ml；in the thoracoscopic combined with posterior approach group, operation time was 320-340minutes,mean 328 minutes, with 450-500ml blood loss, mean 483ml; all patients in the posterior combined with paravertebral approach group required spinal internal fixation, operation time was 185-420minutes,mean