内镜及脑室外引流在侧脑室肿瘤显微手术中的临床应用

Clinical application of neuroendoscope and external ventricular drainage in the microsurgery of lateral ventricular tumors

目的探讨内镜及脑室外引流术(EVD)在侧脑室肿瘤显微手术中的临床应用价值。方法选择1997年6月至2014年3月我院收入的69例侧脑室肿瘤患者,随机分为A组(29例,采用显微外科手术,采用或不采用EVD)和B组(40例,采用内镜+显微外科手术);B组随机分为B1组(22例,另术后应用EVD)和B2组(18例,术后不应用EVD)。分析A、B两组瘤体切除情况和术后3个月格拉斯哥预后评分(GOS)评定情况;分析B1、B2两组术后并发症发生率。结果 A、B两组瘤体组织切除满意率差异具有统计学意义(P<0.01)。两组患者3个月后恢复满意率差异具有统计学意义(P<0.01);B1组与B2组并发症发生情况比较,有统计学差异(P<0.05)。结论内镜+显微手术治疗侧脑室肿瘤能较大程度地切除瘤体组织,显著提高患者生存质量,且术后放置脑室引流管能降低术后并发症的发生率。

Objective To investigate the clinical application value of neuroendoscope and external ventricular drainage （EVD） in the microsurgery of lateral ventricular tumors.MethodsFrom June 1997 to March 2014, 69 cases of lateral ventricular tumors approach at People′s Hospital Affiliated to China Three Gorges University were selected, and were divided randomly into group A （29 cases, treated by microsurgery, EVD or not） and group B （40 cases, treated by neuroendoscope and microsurgery）. Group B were divided randomly into group B1 （22 cases, treated by EVD after operation） and group B2 （18 cases, no EVD）. The data of tumor resection and live standard （GOS score, in 3 months） between group A and B, and the incidence of operative complications between group B1 and B2 were analyzed.ResultsThere was significant difference in the degree of satisfaction with tumor resection （P〈0.01） and live standard （P〈0.01） between group A and B. There was statistical difference on complication rate between group B1 and B2 （P〈0.05）.Conclusions Endoscopic microsurgical treatment of lateral ventricle tumor resection can excise tumor tissue largely, and significantly improve the quality of life of patients, postoperative ventricular drainage tube is an efficient method in lowering operative complications.