不同入路显微外科手术治疗脑胶质瘤的疗效观察研究

Therapeutic Effect of Different Approaches to Microsurgery for Glioma

目的分析脑胶质瘤采用不同入路显微外科手术治疗的临床疗效。方法2013年8月—2017年10月,于武汉中心医院收治的脑胶质瘤患者中选取160例,将肿瘤部位作为依据,合理选择不同入路显微外科手术进行治疗,术后对其随访1年,对手术前后患者各种临床症状改善情况、术后不良反应发生情况以及生活质量情况。结果患者术后1年肿瘤压迫症状、视乳头水肿、恶心呕吐、头部不适发生率分别为0、0、1.25%、1.25%,均低于术前的96.25%、97.50%、97.50%、98.75%,组间差异有统计学意义(P<0.05);与术前对比,术后1年患者认知功能、社会功能、角色功能、身体功能、情感功能各项生活质量评分更高(P<0.05);术后1年随访,只有4例患者有感染现象出现,且对其进行及时处理后完全治愈,未出现其他严重不良反应。结论将肿瘤部位作为依据,合理选择不同入路显微外科手术对脑胶质瘤患者进行治疗,能有效改善各种临床疗效,将不良反应减少,促使患者生活质量提高,可广泛推广于临床。

Objective To analyze the clinical efficacy of different approaches to microsurgery for glioma.Methods From August 2013 to October 2017,160 patients with gliomas admitted to the hospital were selected.The tumor sites were used as the basis for rational selection of different approaches for microsurgery.1 year,the improvement of various clinical symptoms,the occurrence of postoperative adverse reactions and the quality of life of patients before and after surgery were comparde.Results The incidence of tumor compression symptoms,papilledema,nausea and vomiting,and head discomfort in patients 1 year after surgery were 0,0,1.25%,and 1.25%,respectively,which were lower than preoperative 96.25%,97.50%,and 97.50%,98.75%,with significant difference between the groups(P<0.05);Compared with preoperative,the life quality scores of cognitive function,social function,role function,body function and emotional function were higher in the 1 year after operation(P<0.05);After 1 year follow-up,only 4 patients had infection,and they were completely cured after timely treatment.No other serious adverse reactions occurred.Conclusion Based on the tumor site,rational selection of different approaches for microsurgery for glioma patients can effectively improve various clinical effects,reduce adverse reactions,and improve the quality of life of patients.It can be widely used in clinical practice.