论文部分内容阅读
目的:探讨低级别胶质瘤显微外科治疗疗效及影响因素。方法:对65例低级别胶质瘤显微外科治疗回顾性分析,探讨性别、年龄、临床表现、肿瘤生长部位、手术切除程度及个体化综合治疗方式,对患者预后的影响。结果:显微镜下病灶全切除31例,次全切除23例,11例大部分切除,无手术死亡。结果:按WTO分类Ⅰ～Ⅱ级,星型细胞瘤37例,毛细胞型星形细胞瘤11例,多形性黄色瘤型星形细胞瘤3例,少枝胶质细胞瘤9例,少突星形细胞瘤3例,间变性胶质细胞瘤2例。随访1个月至3年,平均23个月,术后早期出现偏瘫6例,失语3例,术后随访3个月后,偏瘫3例、失语2例;46例术前有继发性癫痫病例,29例术后无癫痫发作,8例仍需服药,但癫痫发作明显减少,4例癫痫症状未见好转,5例失随访。结论:低级别胶质瘤是胶质瘤中预后相对较好的类型,显微外科可以提高术中对肿瘤边界的分辨及肿瘤的切除率,为下一步综合治疗提供可靠保障,对患者预后有着重要意义。
Objective: To investigate the effect and influencing factors of microsurgical treatment of low-grade gliomas. Methods: A retrospective analysis of 65 cases of low-grade gliomas treated by microsurgery was conducted to investigate the effects of gender, age, clinical manifestations, tumor growth sites, degree of surgical resection and individualized comprehensive treatment on prognosis of patients. Results: 31 cases were completely resected under microscope and 23 cases were subtotally resected. Most cases were resected in 11 cases without any operative death. Results: According to the classification of Ⅰ ~ Ⅱ in WTO, there were 37 cases of astrocytoma, 11 cases of hairy cell type astrocytoma, 3 cases of pleomorphic astrocytoma, 9 cases of juvenile glioblastoma, Astrocytoma in 3 cases, 2 cases of anaplastic glioblastoma. The patients were followed up for 1 month to 3 years with an average of 23 months. There were 6 cases of hemiplegia and 3 cases of aphasia in the early postoperative period. After 3 months of follow-up, 3 cases were hemiplegia and 2 cases were aphasia; 46 cases had secondary epilepsy Cases, 29 patients without epileptic seizures, 8 patients still need medication, but significantly reduced seizures, 4 cases of epilepsy symptoms did not improve, 5 cases lost follow-up. Conclusion: Low-grade glioma is a relatively good prognosis in glioma. Microsurgery can improve the resolution of intra-operative tumor borderline and tumor resection rate, provide a reliable guarantee for the next comprehensive treatment and have a good prognosis for patients Significance.