235例脑胶质瘤手术治疗临床分析

A Clinical Analysis of Therapeutic Effect of Surgical Treatment in 235 Cases of Brain Glioma

目的：探讨脑胶质瘤手术治疗效果.方法：回顾性分析了2005年3月至2013年9月235例脑胶质瘤患者经显微外科手术和开颅手术切除肿瘤的临床疗效,比较两组手术后不良反应、生活质量及生存时间.结果：显微外科手术139例中,全部切除73例,大部分切除46例,有效率85.6％;开颅手术96例中,全部切除35例,大部分切除30例,有效率67.7％.随访观察前者复发26例,死亡16例,术后不良反应25例,生活质量明显改善85例,生存时间1～3年67 ～113例;后者复发30例,死亡22例,术后不良反应29例,生活质量明显改善43例,生存时间1～3年32 ～66例.两者有效率、复发率、死亡率、不良反应发生率、生活质量改善率及生存率比较,P ＜0.05,差异有统计学意义.结论：显微外科手术明显提高了肿瘤的切除率,提高了生存率,降低了复发率及病死率,延长了患者生存时间,改善了患者生活质量.

Objective：To investigate the clinical therapeutic effect of surgical treatment of brain glioma . Methods：235 cases of brain glioma with microsurgical and craniotomy operation from March 2005 to September 2013 were retrospectively analyzed and compared, with the clinical effi- cacy,adverse reactions, the quality of life and the survival time after operation assessed. Results：Of 139 patients with brain glioma receiving micro- surgical operation, 73 cases were given total resection, 46 cases subtotal resection, with the total efficiency of 85.6 %. Of 96 patients with brain glioma who underwent craniotomy operation, there were 35 cases with total resection and 30 cases with subtotal resection, with the total efficiency of 67.7 %. The result of follow - up visit showed that for the former, there were 26 cases of tumor relapse, 16 cases of death, 26 cases of adverse reaction, 85 cases of life quality improvement, with survival time fi＇om 1 to 3 years in 67 to 113 cases, and for the latter, there were 30 cases of re- lapse, 22 cases of death, 29 cases of adverse reaction, 43 cases of life quality improvement, with survival time from 1 to 3 years in 32 - 66 cases. There was significant difference between mierosurgical and craniotomy group in efficient rate, the recurrence rate, mortality rate, incidence of ad- verse reactions, and the rate of improvement in life quality and survival （ P 〈 0.05 ）. Conclusion：Microsurgical operation can significantly improve the resection rate and survival rate, reduce the relapse and mortality rate, prolong the survival time of patients and promote their life quality.