脑干病变的立体定向治疗

CT guided stereotactic operation for brain stem lesions

目的:评价计算机体层摄影(CT)引导下的立体定向法在治疗脑干病变中的意义。方法:29例病人(脑干肿瘤24例,脑干出血5例),男14例,女15例,平均年龄38岁。采用CT引导下的立体定向法(为Leksell立体定向仪)。治疗种类包括脑干病变的活检、间质内放疗、后装置管放疗及血肿排空术。结果:29例病人均一次穿刺成功,术中无一例死亡。6个月后统计的治疗有效率:好转89％,恶化5.5％,死亡5.5％,主要并发症有意识障碍、恶心呕吐、四肢抽搐、外展神经麻痹等。结论:CT引导下的立体定向法在治疗脑干病变中具有损伤小(不开颅),适应范围广,疗效好,致残、致死率比开颅术低,并发症、后遗症少,以及简便安全等微侵袭的特点。同时具有诊断和治疗的双重作用,是一种有实用价值的治疗方法。

The purpose of this study is to evaluate the importance of CT guided stereotactic operation for brain stem lesions. Method: The stereotactic operation of 29 patients with brain stem tumor (24 cases) and brain stem apoplexy (5 cases) was studies. We performed stereotactic operations for brain stem disorders with Leksell' s stereotactic apparatus, such as biopsy, interstitial radiotherapy, after-fix radioisotopetherapy and homatoma drainage. Result: No operative mortality. The outcome rate of treatment at six months after operation was as follow: improvement in 89% , deterioration in 5.5%, and death in 5. 5 % . The main complications were coma, nausea and vomiting, convulsion and sixth cranial nerve injury etc. Conclusion: This method has many advantages including minimal injury, less operative complications and better results,and it can be used both in diagnosis and treatment for brain stem diseases. It was proved that CT guided stereotactic operation is a reliable and valuable method in the treatment of brain stem lesions.