MRS联合FL导航手术与常规显微外科手术治疗幕上高级别胶质瘤的效果及预后对比

Comparison of the Effects and Prognosis of MRS combined with FL Guided Surgery and Conventional Microsurgery for Supratentorial High-grade Glioma

目的比较磁共振波谱分析(MRS)联合荧光素钠(FL)导航手术与常规显微外科手术治疗幕上高级别胶质瘤的效果及预后。方法回顾性分析62例幕上高级别胶质瘤患者,根据手术方式不同,35例采用MRS联合FL导航手术纳入观察组,27例采用常规显微外科手术纳入对照组。术后比较两组患者的肿瘤全切率,并进行长期随访,观察患者偏瘫情况和预后,记录患者生存时间,比较两组患者的1年存活率。结果观察组患者的肿瘤全切率为94.29%,明显高于对照组的70.37%(P<0.05)。术后1个月,观察组患者的偏瘫情况较对照组有明显好转(P<0.05)。术后3个月,观察组患者的预后良好率为88.57%,明显高于对照组的62.96%(P<0.05)。观察组死亡12例,存活23例,中位生存时间为17个月。对照组死亡17例,存活10例,中位生存时间为14个月。观察组患者1年存活率为80.00%(28/35),对照组患者1年存活率为66.67%(18/27),差异无统计学意义(P>0.05)。生存曲线显示观察组患者的累积存活率高于对照组(P<0.05)。结论幕上高级别胶质瘤采用MRS联合FL导航手术治疗,相比常规显微外科手术能明显提高肿瘤全切率,改善患者偏瘫情况,延长存活时间,患者预后更好。

Objective To compare the effects and prognosis of magnetic resonance spectroscopy(MRS)combined with sodium fluorescein(FL)guided surgery and conventional microsurgery for supratentorial high-grade glioma.Methods 62 patients with supratentorial high-grade glioma were enrolled in the study.According to different surgical methods,35 patients treated with MRS combined with FL guided surgery were included in the observation group while 27 patients treated with conventional microsurgery were included in the control group.The total tumor removal rate was compared between the 2 groups,and long-term follow-up was performed to observe the situation of hemiplegia and prognosis of the patients.The survival time of patients was recorded and the 1-year survival rate was compared between the 2 groups.Results The total tumor removal rate in the observation group was significantly higher than that in the control group(94.29%vs 70.37%)(P<0.05).The situation of hemiplegia in the observation group was significantly better than that in the control group at 1 month after surgery(P<0.05).At 3 months after surgery,the excellent rate of prognosis in the observation group was significantly higher than that in the control group(88.57%vs 62.96%)(P<0.05).In the observation group,12 patients died and 23 patients survived,and the median survival time was 17 months.In the control group,17 patients died and 10 patients survived,and the median survival time was 14 months.The 1-year survival rates of the observation group and the control group were 80.00%(28/35)and 66.67%(18/27),respectively(P>0.05).Survival curves showed that the cumulative survival rate of the observation group patients was higher than that of the control group(P<0.05).Conclusion Compared with conventional microsurgery,MRS combined with FL guided surgery for supratentorial high-grade glioma can significantly improve the total tumor removal rate,relieve hemiplegia,and prolong the survival time of patients,and the prognosis is better.