一期后路全脊椎切除治疗胸腰椎恶性肿瘤的临床疗效研究.doc

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1、一期后路全脊椎切除治疗胸腰椎恶性肿瘤的临床疗效研究【摘耍】目的：探讨一期后路全脊椎切除治疗胸腰椎恶性肿瘤的临床疗效。方法：将本院骨科收治的45例胸腰椎恶性肿瘤患者随机分为两组，均采用一期后路全脊椎切除治疗，其中对照组采取分块切除治疗，试验组采取整块切除治疗。比较两组患者各项手术指标及临床治疗效果。结果：45例患者手术期无1例死亡，两组患者治疗后VAS平均评分均明显低于治疗前，差异均有统计学意义（卩〈0.05）；试验组患者平均手术时间、术中平均出血量、术中平均输血量均明显低于对照组，两组比较差异有统计学意义（P<0.05）；对照组患者8例发生局部复发，5例于随访期间死亡;所有4

2、5例患者Finkel分级均有1级以上恢复。结论：一期后路全脊椎切除治疗胸腰椎恶性肿瘤安全性较高，临床疗效显著，整块切除法较分块切除法疗效更佳。【关键词】脊柱肿瘤；全脊椎切除；整块切除；分块切除TheClinicalEffectofEnBlocSpondylectomyforThoracolumbarSpinalMalignantTumorsviaPosteriorApproach/ZENGFang-jun,CHENRong-chun,YOUHui.//MedicalInnovationofChina,2013,10（35）：029-031【Abstract]Objective

3、：Toinvestigatetheclinicaleffectofenblocspondylectomyviaposteriorapproachforthoracolumbarspinalmalignanttumors.Method:Atotalof45casesofthoracolumbarspinalmalignanttumorsunderwentspondylectomyviaposteriorapproachinthehospital.Allthepatientswererandomlydividedintotwogroups,andthecontrolgroupwe

4、readoptedblockresection,theexperimentalgroupweretakenthewholeblockresection.Theoperationindexesandclinicaltreatmenteffectwerecompared・Result:Therewasnodeathinoperationperiod.TheaverageVASscoreaftertreatmentweresignificantlylowerthanbeforetreatment(1X0.05)；Theaverageoperationtime,intraoperat

5、ivebloodloss,intraoperativebloodtransfusionvolumeofexperimentalgrouppatientsweresignificantlylowerthanthecontrolgroup(P〈0・05)；Eightcasesofpatientswithlocalrecurreneeand5casesdiedduringthefollow-upinthecontrolgroup；AllpatientshadneurofunctionimprovedatleastoneFrankelgradeaftersurgery.Conclus

6、ion：Enblocviatheposteriorapproachforthethoracolumbarspinalmaligriantisreliable,andtheclinicalcurativeeffectisdistinct・Theentireblockexcisionmethodblockexcisionmethodcurativeeffectisbettertheantherone.[Keywords]Spinaltumor；Totalspondylectomy；Enblocresection；PiecemealresectionFirst-authot'sad

7、dress：ThePeople，sHospitalofGanzhouCity,Ganzhou341000,Chinadoi：10.3969/j.issn.1674-4985.2013.35.014胸腰椎恶性肿瘤属于脊柱肿瘤z—,临床上常采用囊内切除或肿瘤刮除外科治疗，但术后复发率较高［1］。近儿年一期后路全脊椎切除术逐渐被许多医师采用，能够满足脊柱肿瘤广泛切除或边缘切除的要求，对提高患者的局部治愈率、生存率及降低术后复发率临床疗效显著［2］。本院自2005年起开始采用一期后路全脊稚切除治疗胸腰稚恶性肿瘤