骨髓瘤_____骨髓瘤；_脊柱；_诊断；

脊柱病变为主的骨髓瘤的诊断和外科治疗

http://www.100md.com 《中国矫形外科杂志》 2006年第9期

骨髓瘤,,骨髓瘤；,脊柱；,诊断；,手术,摘要,关键词,1资料和方法,2治疗方法,3结果,4讨论,参考文献

     摘要：[目的]探讨以脊柱病变为主的骨髓瘤的的诊断方法和外科治疗的指征、方式及效果。[方法]对本科自1996~2004年收治的13例以脊柱病变为主的骨髓瘤患者的临床表现、辅助检查及外科治疗情况进行回顾分析。本组资料13例患者，男性5例，女性8例，平均4767岁。行X线、CT、MRI、ECT、术前/术中病理活检等检查，均行外科手术治疗：经前路椎体肿瘤切除、钛网植骨或骨水泥椎体植入、钢/钛板内固定7例，经后路全脊椎切除、钛网植骨、椎弓根钉固定4例，联合入路肿瘤切除、前路钛网植入、钛板内固定、后路经椎弓根固定2例。[结果]术后患者疼痛症状明显缓解，脊髓或神经根压迫症状改善，生活质量提高，2例截瘫患者Frankel分级分别由B级、C级变为D级，患者均获随访，平均随访3675个月，1例复发，3例死亡。[结论]X线检查可提供诊断线索，CT与MRI在诊断和鉴别诊断中有重要作用，ECT检查可发现全身多个病灶，病理活检是可靠的诊断方法，选择性手术治疗可使患者症状得到明显持久缓解，须结合化疗、放疗等其他治疗，才能得到最好的治疗效果。

     关键词：骨髓瘤；脊柱；诊断；手术

    Diagnosis and surgical treatment of spinal myeloma∥XIE Feibin,LI Jianmin,QIAN Jianrong，et alDepartment of Orthopaedics,Qilu Hospital of Shandong University,Jinan 250012

    Abstract：[Objective]To discuss the diagnosis and surgical treatment of spinal myeloma[Method]To make a retrospective analysis of cliniacal history and operation results of 13 patients with spinal myeloma from 1999 to 2004There were 5 males and 8 females with average age of 4767 yearsThey were diagnosed by Xray,CT,MRI,ECT and biopsyResection of tumor was performed in all cases,of which 7 cases was through anterior approach,4 cases through posterior approach,2 cases through combined approach[Result]The pain was decreased and neurological function was improved in all cases after the surgeryThree death and one recurrence was found during the followup time[Conclusion]Xray,CT and MRI are essential for diagnosis,ECT may help found multiple lesions,biopsy is reliable diagnosable methodSurgery can relived the symptoms obviously,but should be associated with adjuvant treatments ......

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