【作者】 王琛；

【导师】 朱永坚；

【作者基本信息】 浙江大学 ， 临床医学七年制（专业学位）， 2016， 硕士

【摘要】 目的分析椎管内非浸润性血管脂肪瘤的临床特点,探讨分析不同方式手术治疗的安全性及有效性。材料与方法回顾性分析2009年1月至2016年1月我院收治经病理确诊为椎管内非浸润性血管脂肪瘤的患者15例,总结其流行病学特点、临床表现及体征、影像学表现、手术方式及预后,分析、归纳椎管内非侵袭性血管脂肪瘤的临床特点及治疗效果。结果共收集了15例患者的临床资料。其中男6例,女9例,年龄49～77岁,平均60.9±9.3岁,病程20天-6年,平均16个月。患者的症状大多表现为双下肢麻木(8例)、双下肢无力(4例),腰背痛(5例),双下肢疼痛(1例),大小便功能影响(2例)或者临床无症状(1例)。病灶位于胸椎12例,腰椎3例；所有患者均行手术治疗,手术方式：椎板切除术7例,椎板成形术6例；扩大椎板间隙入路1例；经皮脊柱内镜椎板间隙入路1例。均取得满意的结果。结论椎管内非侵袭性血管脂肪瘤肿瘤界限清楚,与周围组织无粘连,手术切除相对较容易。如何在安全前提下尽可能微创的切除肿瘤、最大程度的保持脊柱稳定性是手术方式选择的重点。更多还原

【Abstract】 ObjectiveAnalyze the clinical characteristics of intraspinal non-infiltrated angiolipoma,discuss the safety and availability of minimally invasive surgeries to treat intraspinal non-infiltrated angiolipoma.Materials and methodsRetrospective analysis 15 cases admitted by our hospital on June 2009 to June 2016,whose diagnosis was confirmed as angilipoma by pathology. Summarize their epidemiological characters, clinical preservations and symptoms, imaging findings of the tumors, comparations of every surgical method,and analyze the prognosis. Conclude clinical manifestations and development of treatments of intraspinal angiolipoma.ResultsWe collect 15 cases of intraspinal angiolipoma.6 were male while 9 were female.The average age of them was 60.9±9.3 years old.And the course ranged from 20 days to 6 years whose average was 16 months.The clinical manifestation included numbness and weakness of lower limbs, lumbago and backache or no symptoms.2 of them appeared symptoms of abnormal functions of urination and cacation.The tumor located in thoracic vertebra of 12 cases and 3 in lumbar vertebra. All patients received operations.13 patients underwent laminectomy,and 6 of them underwent laminoplasty.One patient was performed sugery through interlaminar approach.And one was performed with full-endoscopic technique.And all patients acquired satisfying results.ConclusionAll patients we collected of intraspinal angiolipoma acquired good results.Microsurgery and endoscopic surgery obtained total resection.As to the analogous tumor with good prognosis,the consideration of minimally invasive surgery and keep maximum spinal stability is important.更多还原