复发性脑胶质瘤的手术治疗

Surgical treatment of recurrent gliomas

目的探讨复发性脑胶质瘤的手术特点。方法回顾性分析86例复发性脑胶质瘤手术患者的临床资料,归纳其临床、影像学、病理学的特点、分析其手术治疗效果。结果复发性脑胶质瘤的诊断并不困难,再次手术全切除率较高,无死亡率。但是判断手术效果的关键是观察患者手术后是否会改善症状或者是延长生命。结论复发性脑胶质瘤的其生物学行为常常发生明显的变化,多呈浸润性生长,而且生长迅速。病人的生存时间与肿瘤复发后的分级,第一次手术到复发的时间,颅内的部位,肿瘤的形态学的特点和病人的年龄与全身情况有关。但目前对复发性脑胶质瘤通常采用的治疗方案仍以手术为主结合放疗和化疗的综合治疗。精确的手术治疗虽然不能显著提高生存时间,但是可有效地减少死亡率和致残率。

Objective To explore the operative characteristics of the recurrent gliomas. Methods The clinical data of 86 patients with recurrent gliomas, including the clinical characteristics, images and pathological diagnosis were analyzed retrospectively. Rusults The diagnosis of recurrent gliomas is not difficult and the tumor is easy to be totally removed again. The removal rate is 95 % in this group. All patients survived. The relief of symptoms or the prolongation of survival are the key to estimating the effectiveness of the operation. Conclusions The biological character of the recurrent glioma usually changes obviously, most of them grow soakagely and rapidly. Factors affecting the survival time include the malignant grade of the recurrent glioma, interoperation interval, the site of the glioma, tumor histologic type and the ages and performance statue of patients. Nowadays the most common combined therapy for recurrent glioma includes the chemotherapy and radiation therapy following reoperation. Although accurate reoperation could not enhance the survival time prominently, the mortality and disability rate was reduced effectually.