顯微鏡下全切或次全切除術(shù)治療腦膠質(zhì)瘤的綜合療效及預(yù)后

程品文

[摘要] 目的 探討顯微鏡下全切或次全切除術(shù)治療腦膠質(zhì)瘤的綜合療效及預(yù)后。 方法 選取2016年6月～2017年6月于我院就診的80例腦膠質(zhì)瘤患者作為研究對(duì)象。采用隨機(jī)數(shù)字表法將其分為觀察組與對(duì)照組，對(duì)照組40例接受傳統(tǒng)開顱膠質(zhì)瘤切除術(shù)，觀察組40例在顯微鏡下行全切或次全切除術(shù)，比較兩組患者手術(shù)治療的綜合效果及預(yù)后結(jié)局。 結(jié)果 觀察組手術(shù)用時(shí)[（60.74±10.59）min]、平均住院時(shí)間[（7.22±1.35）d]明顯低于對(duì)照組手術(shù)用時(shí)[（91.25±13.47）min]、平均住院時(shí)間[（10.38±2.54）d]，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;兩組術(shù)前定向力、記憶力、注意力、計(jì)算力、回憶能力、語言能力評(píng)分比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）;術(shù)后兩組各項(xiàng)評(píng)分均高于術(shù)前，且觀察組明顯高于對(duì)照組（P<0.05）。術(shù)前兩組腦脊液神經(jīng)肽水平比較，無顯著差異（P>0.05），術(shù)后觀察組腦脊液神經(jīng)肽水平與對(duì)照組比較，存在顯著差異（P<0.05）;兩組術(shù)后并發(fā)癥發(fā)生率比較，無顯著差異（P>0.05）;術(shù)后1年隨訪顯示觀察組復(fù)發(fā)率與死亡率均為2.5%，對(duì)照組復(fù)發(fā)率與死亡率均為2.5%，兩組復(fù)發(fā)率與病死率比較，無顯著差異（P>0.05）。 結(jié)論 采用顯微鏡下全切或次全切除術(shù)治療腦膠質(zhì)瘤療效可靠且安全性高，能夠有效降低患者認(rèn)知功能的損害，促進(jìn)患者腦脊液神經(jīng)肽水平的恢復(fù)，有利于改善患者近遠(yuǎn)期預(yù)后，具有臨床應(yīng)用及推廣價(jià)值。

[關(guān)鍵詞] 顯微鏡下全切或次全切;腦膠質(zhì)瘤;綜合療效;認(rèn)知功能;預(yù)后結(jié)局

[中圖分類號(hào)] R739.41 ? ? ? ? ?[文獻(xiàn)標(biāo)識(shí)碼] B ? ? ? ? ?[文章編號(hào)] 1673-9701（2019）32-0037-04

Comprehensive curative effect and prognosis of microscopic total or subtotal resection for glioma

CHENG Pinwen

Department of Neurosurgery， Gucheng County People's Hospital in Hubei Province， Gucheng ? 441700， China

[Abstract] Objective To investigate the comprehensive curative effect and prognosis of microscopic total or subtotal resection for glioma. Methods Eighty patients with glioma treated in our hospital from June 2016 to June 2017 were selected as the subjects and divided into the observation group and the control group by the random number table method. The control group， consisting of 40 patients， were treated with traditional craniotomy for glioma resection， and the observation group， consisting of 40 patients， were treated with microscopic total or subtotal resection. The comprehensive effects and prognosis outcomes of surgical treatment were compared between the two groups. Results The surgical time [（60.74±10.59） minutes] and the average hospitalization time [（7.22±1.35） days] in the observation group were significantly lower than those [（91.25±13.47） minutes， （10.38±2.54） days] in the control group （P<0.05）. The orientation， memory， attention， calculation， recall and language ability scores were not significantly different between the two groups before surgery（P>0.05）， of which all improved evidently after surgery， but the scores in the observation group were all significantly higher than those in the control group after surgery （P<0.05）. The two groups were not significantly different in the cerebrospinal fluid neuropeptide level before surgery（P>0.05）， but the two groups were significantly different in the cerebrospinal fluid neuropeptide level after surgery（P<0.05）. The two groups were not significantly different in the incidence of postoperative complication （P>0.05）. The recurrence rate and the mortality rate were both 2.5% in the observation group and the recurrence rate and the mortality rate were also both 2.5% in the control group in the postoperative 1-year follow-up， with no significant differences between the two groups（P>0.05）. Conclusion Microscopic total or subtotal resection for glioma is reliable and safe. It can effectively reduce the cognitive function damage and promote the recovery of cerebrospinal fluid neuropeptide levels in patients， which is conducive to improving the patients' short and long term prognosis and is of clinical application and promotion value.