颅内神经节细胞胶质瘤的临床研究

Clinical study on intracranial gangliogliomas

目的探讨颅内神经节细胞胶质瘤的临术特点及外科治疗。方法回顾性分析2006年至2010年间经手术和病理证实的36例颅内神经节细胞胶质瘤患者的临床资料。结果结合神经导航、术中唤醒皮层电刺激功能区描记、术中电生理监测等手段,病变手术全切除20例,次全切除16例,随访3个月～4年,29例患者术前症状明显缓解,4例肿瘤复发。结论神经节细胞胶质瘤多数呈相对良性,尤其是单纯位于颞叶者。癫癎部分性发作为其主要临床表现。治疗上应结合神经导航等技术,在保障安全前提下尽可能全切;对癫癎患者应同时处理癫癎灶;对术后有残留或间变者可给予放疗和化疗;神经节细胞胶质瘤手术预后相对良好。

Objective To explore the clinical features and surgical treatment of patients with intraeranial gangliogliomas（GG）. Methods The clinical data of 36 patients who were underwent operations and were confirmed by postoperative pathology harbored intracranial GG, were analyzed retrospectively. Results Combined with neuronavigation, intraoperative wake-up and functional mapping by cortical electrical stimulation and intraoperative ECoG, total resection was achieved in 20 patients and subtotal reseeetion 16. During a following up from 3 monthg to 4 years of those patients,29 felt relieved apparently and 4 had tumor recurrence. Conclusion Most GG are relatively benign, especially located in the temple lobes. The main clinical symptom of them is partial seizure of epilepsy. Combined with neuronavigation the tumors should be totally removed as safe as possible. Epileptic focus should be treated as well. Radiation therapy or chemotherapy can be used for the residual tumors and anaplastic one. The prognosis of GG is relatively good after operation.