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目的总结脑干肿瘤手术治疗的初步经验及影响疗效的因素,探讨最佳适应证,以期提高该类患者的生存率及生存质量。方法回顾性分析该院2000～2004年9例脑干肿瘤显微外科手术治疗患者的资料,将患者的疗效与临床治疗方案、影像学及病理学检查所见、手术和术式进行对比分析。结果9例患者,全切或次全切7例,2例仅做活检;术后症状明显改善者8例,karnofsky计分80以上;1例中脑肿瘤患者术后症状加重,浅昏迷,自动出院,40d后随访已清醒,可进食,本组无围术期死亡。结论作者认为外生性的肿瘤、脑干内生长的囊性肿瘤及脑干内生长的局限性肿瘤是最佳手术适应证,尤其是外生性的肿瘤,应积极采用手术治疗,局灶型脑干内生肿瘤患者直接手术可以明显改善症状。
Objective To summarize the preliminary experience of surgical treatment of brain stem tumors and the factors influencing the curative effect, and to explore the best indications in order to improve the survival rate and quality of life of these patients. Methods The data of 9 patients with microscopic surgical treatment of brain stem tumors from 2000 to 2004 in our hospital were retrospectively analyzed. The curative effect of the patients was compared with that of clinical treatment, imaging and pathological examination, operation and operation. Results Nine patients underwent either total or subtotal resection in 7 cases and biopsy in only 2 cases. Postoperative symptoms were significantly improved in 8 cases and karnofsky score was 80 or more. One patient with mesencephalic brain tumor had worse postoperative symptoms, coma, and autoactivity Discharged, after 40d follow-up has been awake, can eat, no perioperative death in this group. Conclusion The authors believe that exogenous tumors, cystic tumors growing in the brainstem, and localized tumors growing in the brainstem are the best indications for surgery, especially for exogeneic tumors. Surgical treatment should be used actively and the focal brain stem Endoscopic tumor patients with direct surgery can significantly improve the symptoms.