荧光素钠染色技术在颅内胶质瘤手术中的临床应用

Clinical application of sodium fluorescein staining technique in the surgery for intracranial glioma

目的:探讨荧光素钠染色技术在胶质瘤手术中的应用价值。方法:观察组中对25例胶质瘤患者进行荧光素钠染色,并手术切除,根据肿瘤所在部位,肿瘤位于有利手术区域者11例,不利手术区域14例。对照组中对20例胶质瘤采用传统手术切除,其中有利手术区域7例,不利手术区域13例。结果:观察组中全切14例,其中有利手术区域全切8例;不利手术区域全切6例;对照组中全切7例,其中有利手术区域全切4例;不利手术区域全切3例。观察组中有利手术区域组术前KPS评分(45. 23±12. 35)分、术后(83. 25±13. 78)分,手术前后比较差异有统计学意义(P <0. 01);不利手术区域组术前KPS评分(38. 78±14. 82)分、术后(72. 93±14. 58)分,手术前后比较差异有统计学意义(P <0. 01)。对照组中的结果也类似,但在不利于手术区域,观察组和对照组比较差异有统计学意义(P <0. 01)。术后随访3个月,观察组肿瘤复发者3例,对照组肿瘤复发者6例,均无死亡病例。结论:在胶质瘤手术中使用荧光素钠染色技术,可以提高肿瘤切除率,特别是在不利于手术区域的肿瘤切除。

Objective： To evaluate the application value of sodium fluorescein staining technique in the surgery for intracranial glioma. Methods： In the observation group,25 patients with intracranial glioma were included,in which there were 11 cases with advantageous surgical areas and 14 cases with disadvantageous surgical areas.The sodium fluorescein staining technique was used to define the boundary areas of glioma during the resection.In the control group,20 cases of glioma were removed by traditional surgery,in which there were 7 cases with advantageous surgical areas and 13 cases with disadvantageous surgical areas. Results： In observation group,14 cases were fully resection,8 case with advantageous surgical areas and 6 cases with disadvantageous surgical areas.In control group,7 cases were fully resection,4 case with advantageous surgical areas and 3 cases with disadvantageous surgical areas.In the observation group,the preoperative KPS score （45.23＋12.35） and postoperative KPS score （83.25＋13.78） were significantly different in the favorable operation area group （ P 〈0.01）.The preoperative KPS score and postoperative KPS score were 38.78 （＋14.82） and 72.93 （＋14.58） respectively in the unfavorable operation area group,and the difference was statistically significant before and after operation （ P 〈0.01）.The results were similar in control group,but there was a statistically significant difference between two groups regarding the disadvantageous surgical areas （ P 〈0.01）.The postoperative follow-up visit lasted for 3 months,there were 3 cases and 6 cases suffering from tumor recurrence in observation group and control group,respectively,and no one were dead. Conclusion： The sodium fluorescein staining technique is helpful to improve the resection rate in the surgery for intracranial glioma,especially in disadvantageous surgical areas.