摘要
目的探讨岛叶胶质瘤的手术治疗。方法回顾性分析38例岛叶胶质瘤患者的临床资料。其中纯岛叶5例,额叶-岛叶10例,颞叶-岛叶14例,额叶-颞叶-岛叶9例,均采用翼点或扩大翼点入路手术切除肿瘤。结果肿瘤全切除21例,次全切除7例,大部分切除10例。病理检查结果:星形细胞瘤34例,其中Ⅰ级5例,Ⅱ级22例,Ⅲ级4例,Ⅳ级3例;少枝胶质细胞瘤4例。无手术死亡,术后26例神经功能完好,4例出现神经功能障碍,6例已存在的神经功能障碍在术后无变化,2例已存在的神经功能障碍术后加重。随访22例,时间6～15个月,8例术后复发行再次手术,2例星形胶质细胞瘤Ⅳ级患者2年后死亡,偏瘫、失语各2例。结论应用显微神经外科技术治疗岛叶胶质瘤安全、有效。了解岛叶解剖结构及熟练的显微外科技术有助于最大程度地切除岛叶胶质瘤,减少患者术后神经功能障碍。
Objective To improve the treatment outcomes of insular glioma patients. Methods The clinical data of 38 cases of insular glioma were retrospectively analyzed. The tumor arose from the insular lobe in 5 cases,the frontal and insular lobe in 10 cases,the temporal and insular lobe in 14 cases and the frontal,temporal and insular lobe in 9 cases. All the tumors were resected by craniotomy through pterional approach or amplification of pterional approach. Results The tumor was completely resected in 21 cases, subtotally in 7 cases, and mostly in 10 cases. The pathological examination showed that astrocytoma was found in 34 patients （grade I in 5 cases,grade II in 22 cases,grade III in 4 cases and grade 1V in 3 cases） ,and oligodendroglio- ma in 4 cases. No death occurred during operation. Twenty-six patients gradually recovered. Four patients developed neurological deficits. Pre-existing neurological dysfunctions were not improved in 6 cases and aggravated in 2 cases. Conclusion Micro-neurosurgical technique is safe and effective in the treatment of insular glioma. Mastering the anatomic knowledge and operative skills will help to resect insular glioma in largest measure and decrease the neurological deficits of patients.
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2013年第1期103-105,共3页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
