显微手术治疗侧脑室肿瘤78例临床分析

Microsurgical Treatment of Lateral Ventricle Tumors:Clinical Analysis of 78 Cases

目的讨论不同类型侧脑室肿瘤的手术入路选择及术后恢复的相关因素。方法回顾中国医科大学附属第一医院神经外科2011至2016年显微手术治疗且影像学证实为侧脑室肿瘤的78例临床资料,并进行相关分析。结果 81.3%的患者术前出现颅内压增高,9.5%出现运动障碍,5.8%出现视力视野障碍,3.4%出现癫痫,4.6%无明显临床症状。术后病理结果良性为34例,恶性为44例,部分切除8例,1例活检。全部进行术后随访,随访时间为6～45个月,术后格拉斯哥预后(GOS)评分5分54例,4分16例,3分3例,2分3例,1分2例。相关分析结果显示,男性、高龄、术后病理恶性及肿瘤直径较大与患者的预后显著相关。结论侧脑室肿瘤位置深,手术难度大,应根据肿瘤起源的主体位置合理选择手术入路,最大程度切除肿瘤,减少术后并发症。

Objective To describe the surgical approaches for different types of lateral ventricle tumors and the risk factors related to postoperative recovery.Methods We included 78 patients who visited the neurosurgery department in the First Hospital of China Medical University.Lateral ventricle tumors were detected radiologically and microsurgical treatment was performed between 2011 to 2016.Results Among the enrolled patients,81.3%had intracranial hypertension,9.5%patients had a movement disorder,5.8%had a visual field disorder,3.4%had epilepsy,and 4.6%patients had no obvious clinical symptoms.There were 34 benign tumors and 44 malignant tumors.Eight cases underwent partial resection and one case underwent a biopsy.All 78 patients were followed up for 6 to 45 months.The prognosis was evaluated by postoperative GOS scores.We observed 54 patients with 5 points,16 with 4 points,3 with 3 points,3 with 2 points,and 2 with 1 point each.Conclusion The location of the lateral ventricle is deep and close to many important functional areas.Therefore,surgeries are difficult.The choice of a surgical approach should be based on the tumor location to reduce postoperative complications.Males,elderly patients,the extent of the malignancy,and larger tumors are related to prognosis.