摘要
目的探讨特殊临床表现的椎管内外生长的巨大哑铃形神经鞘瘤诊断与治疗方法。方法回顾研究暨南大学第二临床医学院2011年3月至2013年7月,以非脊柱疾病首诊入院的7例具有特殊临床表现的神经鞘瘤患者的诊疗过程及治疗方法与疾病转归。结果 7例患者中,分别首诊于泌尿外科2例、肝胆外科1例、妇科2例、疼痛科1例、理疗科1例,经会诊或进一步检查后纠正诊断。7例患者中,5例伴有不同程度的椎管内神经受压症状,2例无明显椎管内神经受压症状,影像学检查提示神经源性肿瘤可能,后行瘤体切除术,术后病理检查为神经鞘瘤。术后平均随访1.3年,患者症状消失,未出现复发和新发症状。结论部分椎管内外生长的哑铃型神经鞘瘤有其特殊的临床表现,以腹部肿物压迫为初始症状,而椎管内神经受压症状出现较迟,临床医师应考虑到此病的可能性并进行进一步的检查,以便及早正确诊断。椎管内外联合包膜外切除术是治疗神经鞘瘤的有效方法。
Objective To investigate the specific clinical manifestations,surgery treatment of internal and external growth of thoracolumbar intraspinal schwannomas and provide evidences for early diagnosis and treatment.Methods From March 2011 to July 2013,medical records of seven patients with spinal schwannoma were retrospectively reviewed,which were first diagnosed with non-spinal diseases. Results Among seven patients,two patients admitted to urology for the first time,one patient in department of hepatobiliary surgery,two cases in department of gynecology,one patient in department of pain,one case in department of physiotherapy.Patients got the right diagnosis after proper consultation and further examination.Among seven patients,five patients with different degree of spinal canal nerve compression symptoms including leg pain,numbness,weakness while two cases with no obvious symptoms.It may be neurogenic tumors by CT and MRI examination.Schwannoma were confirmed by postoperative pathological examination.In the following 1 .3 years,basic symptoms disappeared,it didn′t appear recurnence and new symptoms.Conclusions Parts of the internal and external growth of thoracolumbar intraspinal schwannomas have their specific clinical manifestations：abdominal mass oppression for initial symptoms,while spinal nerve compression symptoms appear later.Thinking of the possibility of the disease and relevant examination are the keys to the appropriate diagnosis and treatment.Combined extracapsular resection inside and outside the spinal canal is an effective way for internal and external growth of thoracolumbar intraspinal schwannomas.
出处
《中华诊断学电子杂志》
2014年第1期35-37,共3页
Chinese Journal of Diagnostics(Electronic Edition)
基金
国家自然科学基金(30973031/C160701)
关键词
神经鞘瘤
诊断
治疗
Neurilemmoma
Diagnosis
Treatment
