摘要
目的探讨外科手术在延迟性颞叶放射性脑病治疗中的应用价值。方法回顾分析我科2010年8月至2014年12月采用手术治疗的14例延迟性颞叶放射性脑病患者临床资料,总结分析其临床表现、影像学检查、术中所见、术中CT应用、病理检查、术后护理及手术疗效。结果术后患者恢复良好,9例病人头晕、头痛等症状完全缓解;4例部分缓解;1例无明显改善。手术前后MRI检查对比可见病灶坏死组织大部切除;病理检查示脑组织变性、坏死,水肿明显,未见肿瘤组织。8例患者使用术中CT,均准确切除坏死脑组织,且未见术野内外发生出血;6例未使用术中CT监测,1例出现对侧硬膜外血肿,行二次手术清除血肿。结论对于延迟性颞叶放射性脑病患者,适时采取积极手术治疗,辅以术中CT监测,加强围手术期护理,可改善此类患者的症状;早期诊断,提高患者生存质量。
Objective To explore the value of surgical treatment in delayed temporal lobe radiation encephalopathy..Methods The clinical data of 14 patients with temporal lobe radiation encephalopathy who admitted to our hospital from August 2010 to December 2014 were retrospectively analyzed and all of them were treated by surgery..The clinical manifestations,.imaging tests,.introoperative findings, application of intro-operative CT（i CT）, pathological examination, postoperative nursing and surgical outcomes were summarized and analyzed..Results Postoperative patients recovered well. The symptoms in 9 patients who complained headache and dizziness,.were completely recovered,and 4 patients were partly alleviated and only a patient had little improvement. Magnetic resonance imaging indicated that the focal necrotic tissue was mostly resected. The pathological examination showed that no tumor tissues was discovered and the removed tissues presented significant degeneration,necrosis and edema. During the operation, 8 patients adopted i CT monitoring, as a result, necrotic tissues of the patients were resected precisely. Of the remaining 6 patients without i CT monitoring during surgery, one occurred contralateral subdural hematoma and consequently suffered an additional operation aiming to clear the hematoma. Conclusion For the patients with delayed temporal lobe radiation encephalopathy, adoption of opportunely positive surgical treatment coupled with i CT monitoring,.enhancement of perioperative care could alleviate the symptoms of those patients..Early diagnose and improve the life quality of patients.
出处
《岭南现代临床外科》
2015年第6期714-718,共5页
Lingnan Modern Clinics in Surgery
