丘脑胶质瘤的临床特征与手术治疗的分析

Analysis of clinical features and surgery treatment of thalamic gliomas

目的研究丘脑胶质瘤的临床特征、诊疗方法和手术技巧。方法回顾性分析我院经手术治疗的39例丘脑胶质瘤患者的临床表现、肿瘤影像学特点和手术治疗效果。结果丘脑不同类型胶质瘤影像学表现、全切率不尽相同。病程7d～3．5年,平均3．1月。肿瘤颅内压增高症状最为常见(90%),轻偏瘫56%,不自主运动10%,智力减退或精神症状30%;全组患者肿瘤手术全切率为53%,次全切率为29%,部分切除率为18%;出院时好转、稳定者占79%,恶化及出现新体征者占21%;手术死亡率为0。结论MRI是目前诊断丘及肿瘤的最好检查方法。肿瘤的病理分类与临床症状、影像特征及手术效果均有关。

Objective To further study the clinical features,diagnosis, and surgery treatment of thalamie gliomas. Methods Totally 39 patients with thalamic gliomas received surgery operations in our hospital from Jan 1999 to Nov 2006. The clinical data,neuroimages,and operative feasibility were analyzed. Results Different thalamic gliomas showed different features. In this series, the course of disease was from 7 days to 3.5 years ,average 3. 1 months, the most common symptom was intracranial hypertention （ 90%）, hemiparesis （56 %）, involuntary （10% ）,intelligence deeresenee and psychiatric symptom （30%）,total excision rate of the tumor was 53%, subtotal 29% ,partial 18% ,and operative mortality 0%. Among 39 patients,79% patients had been improved and stable in their symptoms after operation,and 21% deteriorated or having transitory new signs. Conclusion MRI is the best method in the diagnosis of thalamic gliomas. The pathological classification of tumors is correlated with all the clinical syndrome,theneuroimage features and surgery effects.