显微外科手术治疗脑胶质瘤的临床有效性及安全性

Clinical efficacy and safety of microsurgery treatment for brain gliomas

目的探讨显微外科手术治疗脑胶质瘤的临床有效性及安全性。方法选取2018年5月至2020年6月九江市第三人民医院诊治的90例脑胶质瘤患者作为研究对象,采用随机数字表法分为对照组与研究组,各45例。对照组行开颅手术治疗,研究组行显微外科手术治疗,比较两组临床疗效、并发症发生情况、临床指标、免疫功能、神经功能及肢体功能。结果研究组治疗总有效率为93.33%,高于对照组的77.78%,差异有统计学意义(P<0.05);研究组并发症发生率为8.89%,低于对照组的24.44%,差异有统计学意义(P<0.05)。研究组术中出血量少于对照组,手术时间、术后下床时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。术后,两组CD4^(+)水平高于术前,CD8^(+)水平低于术前,研究组CD4^(+)/CD8^(+)高于术前,对照组CD4^(+)/CD8^(+)低于术前,且研究组CD4^(+)水平、CD4^(+)/CD8^(+)均高于对照组,CD8^(+)水平低于对照组,差异有统计学意义(P<0.05)。术后,两组美国国立卫生研究院卒中量表(NIHSS)评分低于术前,Fugel-Meyer评价量表(FMA)评分高于术前,且研究组NIHSS评分低于对照组,FMA评分高于对照组,差异有统计学意义(P<0.05)。结论显微外科手术治疗脑胶质瘤疗效确切,可减少术中出血量,改善神经功能和肢体功能,安全性好,值得临床推广应用。

Objective To investigate the clinical efficacy and safety of microsurgery in the treatment of brain glioma.Methods A total of 90 brain glioma patients diagnosed and treated in Jiujiang Third People's Hospital from May 2018 to June 2020 were selected as the study subjects,and they were divided into the control group and the study group by random number table method,with 45 cases in each group.The control group re-ceived craniotomy and the study group received microsurgery.The clinical efficacy,complications,clinical indicators,immune function,neurological function and limb function were compared between the two groups.Results The total effective rate in the study group was 93.33%,which was high-er than 77.78%in the control group,the difference was statistically significant(P<0.05).The incidence of complications in the study group was 8.89%,which was lower than 24.44%in the control group,and the difference was statistically significant(P<0.05).The intraoperative blood loss in the study group was less than that in the control group,the operation time,postoperative getting out of bed time and hospital stay were shorter than those in the control group,the differences were statistically significant(P<0.05).After surgery,the CD4^(+) level of the two groups was higher than be-fore surgery,and CD8^(+) level was lower than before surgery,CD4^(+)/CD8^(+) in the study group was higher than before surgery,CD4^(+)/CD8^(+) in the control group was lower than before surgery,and CD4^(+) level and CD4^(+)/CD8^(+) in the study group were higher than those in the control group,and CD8^(+) level was lower than that in the control group,the differences were statistically significant(P<0.05).After surgery,the score of National Institutes of Health stroke scale(NIHSS)was lower than before surgery,and the score of Fugel-Meyer Evaluation Scale(FMA)was higher than before surgery,and the NIHSS score in the study group was lower than that in the control group,and the FMA score was higher than that in the control group,the dif-ferences were statistically significant(P<0.05).Conclusion Microsurgery is effective in the treatment of brain glioma,can reduce intraoperative blood loss,improve nerve function and limb function,and is safe and worthy of clinical promotion and application.