以癫为首发症状的幕上星形细胞瘤的诊疗体会

The experience of diagnosis and treatment of supratentorial astrocytoma with the first sign of seizure

目的探讨癫与星形细胞瘤的关系及影响术后癫控制的因素。方法回顾性分析35例以癫为首发症状的星形细胞瘤患者,运用SPSS 15.0对术中肿瘤切除程度和术前癫病程分别与术后6个月癫控制情况进行卡方检验。结果35例病人全切25例,次全切6例,部分切除4例;病理诊断(WHO)Ⅰ～Ⅱ26例,Ⅲ～Ⅳ9例;术前癫病程1～6个月13例,>6个月～2年17例,2年以上5例。分别与术后6个月癫控制情况行卡方检验,P值分别为0.016、0.039,差异均有统计学意义。结论以癫为首发症状的脑星形细胞瘤多为低级别肿瘤,手术全切及术前癫病程短者术后癫较易控制。

Objective To investigate the correlation of seizure with astrocytoma and to identify the factors that influenced postoperative seizure control. Methods Thirty-five patients with astrocytoma which first sign was seizure were retrospectively analyzed. SPSS 15.0 was used to analyze the correlation of not only tumor resecting extent but also the history of seizure before surgery with postoperative control. The statistical method was Chi-Square test. Results Among 35 patients,gross-total resection of 25 cases, subtotal resection of 6 cases, biopsy of 4 cases. Pathological diagnosis （WHO） ： grade Ⅰ-Ⅱ of 26 cases, Ⅲ-Ⅳ of 9 cases. The history of seizure before surgery 1-6 months of 13 eases,〉6-24 months of 17 eases〉24 months of 5 cases . After Chi-Squre test, the scores of P were respective 0. 016 and 0. 039, both were less than 0.05. Conclusion The astrocytoma with first sign of seizure is the most lower grade tumor . A shorter history seizures and gross-total resection are the advantageous factors of controlling postoperative seizure easily.