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題名 | 椎管內脊髓腫瘤之延遲診斷及預後之探討=A Survey about the Causes of Delay Diagnosis and Prognosis in Spinal Tumors |
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作者 | 謝宜熹; 楊百嘉; | 書刊名 | 復健醫學會雜誌 |
卷期 | 25:1 1997.06[民86.06] |
頁次 | 頁51-56 |
分類號 | 416.292 |
關鍵詞 | 脊髓腫瘤; 症狀; 診斷; Spinal tumors; Symptoms; Diagnosis; |
語文 | 中文(Chinese) |
中文摘要 | 本文係回顧並追蹤過去10年間在馬偕紀念醫院住院及接受手術之50位椎管內脊髓 腫瘤之病例。腫瘤之病理診斷以神經鞘細胞瘤最多 (64%),腦膜瘤居次 (22%)。其症狀出現 至被診斷出腫瘤之平均時間為 1.32 年 (1/2 月 - 7 年 )。 起初最常見之症狀為背痛及肢 體麻木感,腫瘤常至肢體無力或大小便障礙出現時才被診斷出來。而最初之診斷以椎間盤突 出症及脊椎關節炎最多見。50 人中有 6 人曾於腫瘤發現前接受過物理治療。腫瘤開刀之預 後良好,但仍與其術前之神經功能狀態有關。故對求診於復健科之長期背痛或肢體麻木感的 病患應做詳細之神經學檢查,並將脊髓腫瘤納入鑑別診斷,以期對脊髓腫瘤能早期診斷、早 期治療及獲得良好之預後。 |
英文摘要 | Fifty patients with primary spinal tumors operated in Mackay memorial hospital between 1985 and 1995 were reviewed retrospecively. The commonest diagnoses were nerve sheath cell tumors (neurilemmomas and schwannoma) and emningioma. The mean delay in diagnosis was 1.32 years (range: half month to 7 years). The commonest intial symptoms were back pain and numbness over limbs, but later muscle weakness and sphincter disturbances came to predominate. Most patients visited orthopaedic surgeons and neurologist at beginning, and were initially diagnosed as spondylosis or herniated intervertebral disc. Six patients had been received physical therapy under the diagnosis of HIVD or spondylosis before the spinal tumors were found. Symptoms were partially or completely relieved in the majority of patients after operation. Delay in diagnosis of these tumors arises from failure to consider the diagnosis in patients with longstanding bakc pain or neurologic problems. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。