丘脑肿瘤的临床手术治疗

Clinical surgical treatment of thalamic tumor

目的探讨丘脑肿瘤的临床手术治疗。方法回顾性分析20例丘脑肿瘤病人的临床资料,均行显微手术切除,其中经皮质侧脑室入路9例,经纵裂胼胝体入路4例,经外侧裂岛叶入路4例,经顶间沟入路3例。观察术后临床症状及神经功能改善情况。结果肿瘤全切除7例,次全切除8例,部分切除5例,无手术死亡病例。术后短期内病人临床症状和神经功能改善14例,无明显变化4例,加重2例。出院时KPS评分:90~100分9例,60~80分6例,30~50分3例,10~20分2例。结论对于丘脑肿瘤显微手术治疗,个性化选择入路、掌握手术要点及方法是提高肿瘤切除程度、减少术后并发症的前提和基础,是提高术后病人生活质量的关键。

Objective To explore the clinical surgical treatment of thalamic tumor. Methods Clinical data of 20 patients with thalamic tumor undergoing microsurgical resection were analyzed retrospectively, including via transcortical lateral ventricle approach in 9 patients, interhemispheric transcallosal approach in 4, transsylvian transinsular approach in 4 and transinterparietal fissure approach in3. The improvements of clinical symptoms and neurological function were observed. Results Total tumor resection was achieved in 7 patients, subtotal resection in 8 and partial resection in 5, no patient died in surgery. The clinical symptoms and neurological functions improved in 14 patients, had no significant change in 4, aggravated in 2 in the short time after surgery. The KPS scores at discharge were as follows： 90 to 100 scores in 9 patients, 60 to 80 scores in 6, 30 to 50 scores in 3 and 10 to 20 scores in 2. Conclusion Individualized approach selection and mastery of surgical essential and methods are the prerequisites and basis for improving the tumor resection degree and reducing postoperative complications in patients with thalamic tumors undergoing microsurgery, and the key to improving patients＇ quality of life after surgery.