瘤内切瘤术治疗颅内巨大肿瘤的效果分析

目的分析瘤内切瘤术治疗颅内巨大肿瘤患者的可行性、有效性。方法以2010-07—2014-07我院门诊收治的86例颅内巨大肿瘤患者为研究对象,采用双盲法随机分为对照组与治疗组各43例。对照组采用传统开颅切除肿瘤,治疗组采取瘤内切瘤术治疗,记录手术情况,统计术后并发症情况及治疗效果。结果治疗组出血量、输血量较对照组少,差异有统计学意义(P<0.05);治疗组并发症、疾病复发率分别为7.0%、7.0%,明显低于对照组的18.6%、18.6%,差异有统计学意义(P<0.05)。结论对颅内肿瘤体积较大者,使用瘤内切瘤术治疗,患者术后并发症少、创伤小、复发率低。

瘤内切瘤术治疗颅内巨大肿瘤的临床效果探讨

目的探讨瘤内切瘤术治疗颅内巨大肿瘤的临床效果。方法选取我院2014年3月—2017年6月收治的64例颅内巨大肿瘤患者为研究对象,按治疗方案的不同分为常规组(传统肿瘤开颅切除术)和参照组(瘤内切瘤术)。比较2组患者的手术相关指标及术后并发症发生率。结果参照组患者手术相关指标优于常规组,差异均有统计学意义(P<0.05)。参照组患者的术后并发症总发生率为3.13%,明显低于对常规组的18.78%(P<0.05)。结论与传统肿瘤开颅切除术相比,采用瘤内切瘤术对颅内巨大肿瘤患者进行治疗,可在减少术中出血量与手术耗时的同时有效降低术后并发症发生率,有利于优化临床疗效和提高预后效果,值得借鉴。

用瘤内切瘤术治疗颅内巨大肿瘤的效果分析

目的 :探讨用瘤内切瘤术治疗颅内巨大肿瘤的临床效果。方法 :对2013年6月~2014年6月期间我院收治的31例颅内巨大肿瘤患者的临床资料进行回顾性研究。我院使用瘤内切瘤术对这31例患者进行了治疗。治疗结束后,观察这31例患者肿瘤的切除情况、术中的死亡率、发生术后并发症的几率和手术前后Karnofsky(卡氏指数,用于评价人的健康状况)的评分。结果 :在这31例患者中,有20例患者的肿瘤获得了完全切除,有9例患者的肿瘤获得了次全切除,有2例患者的肿瘤获得了大部分切除。在手术过程中,这31例患者中无人死亡,死亡率为0。在手术后,这31例患者中有1例患者发生了并发症,并发症的发生率为3.2%。这31例患者手术后Karnofsky的评分明显高于手术前,组内比较差异具有显著性(P<0.05)。结论:用瘤内切瘤术治疗颅内巨大肿瘤具有效果好、安全性高、可改善患者的健康状况等优点。因此,该手术可作为临床上治疗颅内巨大肿瘤的优选方法。

探讨瘤内切瘤技术在巨大颅内肿瘤切除中的应用

目的探讨在手术切除颅内巨大或者大型肿瘤时瘤内切瘤技术的应用价值及其临床效果。方法我院自2007年6月至2011年1月住院治疗的48例颅内肿瘤患者采用瘤内切瘤微创技术切除最大径为4~7cm的颅内巨大或者大型肿瘤。该手术的技术要点如下：在手术中选取最合适的入路,在此处建立一有效的微创的显露通道,肿瘤起始显露只要适宜安全便利的实施瘤内切瘤即可;针对有瘤蒂的脑膜瘤患者则应该从蒂部开始切除,在肿瘤的最浅表处开始切除胶质瘤和听神经瘤,否则则采取从中央开始切除的方案,在切除中采用瘤内层层推进的方式,切记不要突破存在于肿瘤和脑组织之间的胶质增生带或者肿瘤包膜,最后通过牵引瘤壁和显微分离争取扩大切除或者全切除肿瘤。结果 48例患者中有27例全切除,16例次全切出,5例大部分切除。其中有1例患者术后发生瘤腔积血再行手术清除,1例发生脑室内感染,2例在术后出现了面神经瘫痪（H-BIII级）,经过有效的控制和治疗,3个月之后患者身体康复。通过最近对患者随访（平均16个月）,胶质细胞瘤1例、嗅神经细胞瘤3例、听神经瘤1例总计5名患者复发,再次行手术治疗。患者在术中平均出血量〈400mL,输血量200mL,没有出现死亡病例。结论在对颅内巨大型肿瘤患者手术切除时,科学合理的充分运用瘤内切瘤技术,可以在实现较好切除肿瘤的同时,明显的减少手术损伤神经和血管结构,取得最佳的临床治疗效果,瘤内切瘤在治疗颅内巨型肿瘤中具有极大的实用价值可广泛的推广。

Risk factors for metachronous gastric carcinoma development after endoscopic resection of gastric dysplasia: Retrospective, single-center study

To determine the gastric adenocarcinoma (GAC) occurrence rate and related factors, we evaluated the follow-up results of patients confirmed to have gastric dysplasia after endoscopic resection (ER). METHODSWe retrospectively analyzed the medical records, endoscopic examination records, endoscopic procedure records, and histological records of 667 cases from 641 patients who were followed-up for at least 12 mo, from among 1273 patients who were conformed to have gastric dysplasia after Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) of gastric mucosal lesions between January 2007 and August 2013 at the Chungnam National University Hospital. RESULTSThe mean follow-up period was 33.8 mo, and the median follow-up period was 29 mo (range: 12-87). During the follow-up period, the occurrence of metachronous GAC was 4.0% (27/667). The mean and median interval periods between the occurrence of metachronous GAC and endoscopic treatment of gastric dysplasia were 36.3 and 34 mo, respectively (range: 16-71). The factors related to metachronous GAC occurrence after ER for gastric dysplasia were male sex (5.3% vs 1.0%), open-type atrophic gastritis (9.5% vs 3.4%), intestinal metaplasia (6.8% vs 2.4%), and high-grade dysplasia (HGD; 8.4% vs 3.2%). Among them, male sex [OR: 5.05 (1.18-21.68), P = 0.029], intestinal metaplasia [OR: 2.78 (1.24-6.23), P = 0.013], and HGD [OR: 2.70 (1.16-6.26), P = 0.021] were independent related factors in multivariate analysis. Furthermore, 24 of 27 GAC cases (88.9%) occurred at sites other than the previous resection sites, and 3 (11.1%) occurred at the same site as the previous resection site. CONCLUSIONMale sex, intestinal metaplasia, and HGD were significantly related to the occurrence of metachronous GAC after ER of gastric dysplasia, and most GACs occurred at sites other than the previous resection sites.