丘脑肿瘤的外科治疗

SURGICAL TREATMENT QF THALAMIC TUMORS

本文报告17例丘脑肿瘤,经病理证实为各类型神经胶质瘤。本组病人均经手术,部分或次全切除了肿瘤。手术结果:显效7例,改善5例,无改善2例,加重2例,术后死亡1例,手术死亡率为5.9％。一般认为,丘脑肿瘤位于脑深部,周围结构重要,手术有一定困难。但如应用显微外科技术和超声外科吸引器(CUSA),以及术者的细致操作下,可望获得良好效果。

In this article,17 cases of thalamic tumor are reported.It was 1.1% of our treated 1522 intracranial tumors during the same period. The main clinical manifestations beside the most common symptoms of increase intracranial pressure, the focal signs were hemiparesis in 14 cases, hemihypesthesia in 7,homonymous hemianopsia in 3, and spontaneous numbness and burning pain of contralateral side in 5.The diagnosis was confirmed by ventriculography and CT scanning.The pathological diagnosis were astrocytoma in 8 cases, glioblastoma multiforme in 5,oligodendroglioma,oligodendroglioblastoma,ependymoblastoma and polar spongioblastoma each in 1 case.In this series,all patients were opereted. The tumors were removed with subtotal resection in 3 cases,extensive resection in 8. partial resection in 6.The results of operation were markedly improved in 7 cases, improved in 5, unimproved in 2, aggravated in 2, died in 1. The operative mortality was 5.9%.Follow-up study was obtained in 11 patients, of whom 3 patients died within 2 years after operation.4 patients died in 2-4 years. 4 patients are still survival, among them, 2 patients survived for 12 and 16 years and are now living and working well.In discussion, the authors emphasize, the thalamic tumor is deep seated and surrounded by important structurs, the operative intervension is still a difficult problem, but under the use of microsurgical technique, bipolar electrocoagulation and cavitron ultrasonic surgical aspirator,good results would be achieved in most patients.