丘脑胶质瘤的外科治疗

SURGICAL TREATMENT OF THALAMIC GLIOMAS

１９８３年至１９９３年，作者等收治经病理证实的丘脑胶质瘤３０例，其中活检８例，常规开颅手术切除肿瘤１５例，ＣＴ定位开颅显微激光切除肿瘤７例，无手术死亡，２５例获得随访（平均随访３．５年），１５例生存，平均生存２．８年，１０例死亡，平均生存０．９年。作者认为无颅内压增高、占位效应不明显的丘脑胶质瘤首选活检加放疗；颅内压增高严重，占位效应明显者宜开颅切除肿瘤。肿瘤较小者选择立体定向显微激光技术切除可获得较高的术后生存质量；肿瘤较大者以常规开颅手术切除为佳。

hirty cases of histologically proven gliomas originating in the thalamus weretreated surgically in Huashan Hospital between 1 983 and 1993.Of them,biopsy wascarried out in 8,conventional craniotomy with tumor resection in 15,CT-guided stereo-tactic laser microsurgery in 7.There were no operative deaths. In follow-up,15 pati-ents are still alive after a mean survival time of 2.8 years,10 patients died after amean survival time of 0.9 year,The authors recommend biopsy followed by radiationfor those who have no intracranial hypertension as the treatment of choice,and tumorresection for those patients with serious intracranial hypertension and significant effectfrom tumors.The patients with smaller tumors treated by stereotactic laser microsur-gery may get desirable quality of life postoperatively. Those patints with largertumors should be operated on conventionally.