老年胶质瘤的围手术期处理(附58例报告)

Perioperative management in aged patients with gliomas(report of 58 cases)

目的 探讨老年胶质瘤围手术期的处理方法和注意事项。方法 回顾性分析2010~2015年手术治疗的58例老年胶质瘤的临床资料。结果 肿瘤全切除20例,部分切除27例,活检术11例。无手术死亡病例。术后4例失语加重,3例颅内感染,5例肺部感染,1例术区出血。结论 老年胶质瘤手术方案应本着功能为先的原则,制定个体化方案,完善术前检查和评估,严格控制手术适应证,术后积极预防和处理并发症,提高患者生活质量。

Objective To sumarize the experience in perioperative management in elderly patients with glioma. Methods The clinical data of 58 elderly patients with gliomas who underwent microsurgery between 2010 and 2015 in Pekin Union Hospital were analyzed retrospectively. Results Total and partial resections of tumors were achieved in 20 patients （34.5%） and 27 （46.5%）, respectively. The biopsies were performed in 11 patients （19%）. The aphasia worsened in 4 patients after operation. Postoperative intracranial infections and pulmonary infections ocurred in 3 and 5 patients, respectvely. Conclusion The resection of gliomas in elderly patients should be based on the principle of functionality first. Developing individualized programs, improving the preoperative examination and assessment, controlling strictly the surgical indications, preventing and managing postoperative actively complications are helpful to improve the quality of life.