多模态下神经内镜联合显微技术在手术治疗囊实性脑肿瘤中的应用

Application of multimodal neuroendoscopy combined with microsurgery in the surgical treatment of cystic and solid brain tumors

目的探讨多模态下神经内镜联合显微技术在手术治疗囊实性脑肿瘤中的应用价值。方法选择2016年2月至2019年2月广西壮族自治区梧州市工人医院(广西医科大学第七附属医院)收治的50例囊实性脑肿瘤患者为研究对象,按随机数字表法将患者分为两组,对照组(25例)采用显微外科手术治疗,观察组(25例)采用显微外科手术联合神经内镜辅助治疗。所有患者术后复查CT或MRI,观察并对比两组肿瘤切除率的差异,并对比两组术后并发症、格拉斯哥预后量表(GOS)评分,所有患者随访至术后12个月,观察两组患者肿瘤复发率、病死率。结果观察组肿瘤全部切除率80.00%(20/25),对照组48.00%(12/25),两组比较差异有统计学意义(P<0.05),观察组术后GOS评分高于对照组[(4.52±1.73)分比(3.65±1.15)分,t=2.094,P=0.041]。两组术后并发症发生率、肿瘤复发率、病死率比较差异无统计学意义(P>0.05)。结论多模态下神经内镜联合显微技术可明显提高囊实性脑肿瘤全部切除率,改善预后,且不增加手术风险。

Objective To investigate the value of multi-modal neuroendoscopy combined with microscopy in the treatment of solid cystic brain tumors. Methods Fifty patients with cystic solid tumors admitted to Wuzhou Worker′s Hospital(the Seventh Affiliated Hospital of Guangxi Medical University) from February 2016 to February 2019 were enrolled. The patients were divided into two groups by random number table method. The patients in control group (25 cases) received microsurgery, and the patients in observation group (25 cases) received microsurgery combined with neuroendoscopy. All patients underwent CT or MRI. The differences in tumor resection rate between the two groups were observed and compared. The postoperative complications and Glasgow Outcome Scale (GOS) scores were compared between the two groups. All patients were followed up for 12 months after surgery. The tumor recurrence rate and mortality rate of the two groups were compared. Results The total resection rate of the tumor in observation group was 80.00%(20/25), and in control group was 48.00%(12/25), and there was significant difference (P < 0.05). The postoperative GOS score of observation group was higher than that of control group:(4.52 ± 1.73) scores vs.(3.65 ± 1.15) scores, t=2.094, P=0.041. The incidence of postoperative complications, tumor recurrence rate and the mortality rate between two groups had no significant difference (P > 0.05). Conclusions Multi-modal neuroendoscopy combined with microscopy can significantly improve the total resection rate of cystic brain tumors and improve the prognosis without increasing the risk of surgery.