摘要
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临床效果。方法回顾性分析2017年1月至2019年1月期间自贡市第四人民医院神经外科收治的80例幕上高级别胶质瘤患者的临床资料,其中51例实施MRS联合FL导航手术,纳入观察组,29例实施常规显微外科手术,纳入对照组。比较两组患者围术期指标(手术时间、住院天数)、肿瘤切除率、术后肢体功能运动情况、术后3个月、6个月、12个月生存质量[卡氏功能状态评分(KPS)]评分,以及术后随访情况[肿瘤无进展生存时间(PFS)、1年生存率]。结果两组患者的手术时间比较差异无统计学意义(P>0.05);观察组患者的住院天数为(7.22±0.85)d,明显短于对照组的(24.68±0.73)d,肿瘤全切率为90.20%,明显高于对照组的51.72%,差异均有统计学意义(P<0.05);观察组患者术后偏瘫或肌力下降比例为9.80%(5/51),低于对照组的44.83%(13/29),差异有统计学意义(P<0.05);观察组和对照组患者KPS评分术后3个月[(91.97±4.26)分vs(88.73±6.58)分]、6个月[(85.47±5.95)分vs(81.33±4.79)分]、12个月[(81.92±7.32)分vs(7.48±6.73)分]比较,观察组明显高于对照组,差异均有统计学意义(P<0.05);观察组患者平均PFS和1年生存率分别为(13.37±1.75)个月、78.43%,分别与对照组的(12.72±1.69)个月、75.86%比较,差异均无统计学意义(P>0.05)。结论与常规显微外科手术相比,MRS联合FL导航手术治疗幕上高级别胶质瘤可提高全切率,同时更好地保护患者的肢体运动功能,提高生存质量,但暂无证据表明该手术可延长患者生存期。
Objective To compare the clinical effects of magnetic resonance spectroscopy(MRS)combined with fluorescein(FL)-guided surgery and conventional microsurgery in the treatment of high-grade supratentorial glioma.Methods The clinical data of 80 patients with high-grade supratentorial glioma in Department of Neurosurgery,Zigong Fourth People’s Hospital from January 2017 to January 2019 were retrospectively analyzed.Among them,51 patients who underwent MRS combined with FL-guided surgery were included in the observation group,and 29 patients who underwent conventional microsurgery were enrolled into the control group.The perioperative indicators(operative time,length of hospital stay),surgical resection rate,postoperative limb motor function,quality of life(Karnofsky Performance Status Score,KPS)at 3 months,6 months and 12 months after surgery and postoperative follow-up status(tumor progression-free survival[PFS],1-year survival rate)were compared between the two groups.Results There was no significant difference in the operative time between the two groups(P>0.05).The length of hospital stay in observation group was(7.22±0.85)d versus(24.68±0.73)d in the control group,and the total tumor resection rate was 90.20%versus51.72%in the control group(P<0.05).The proportion of postoperative hemiplegia or muscle weakness in the observation group was 9.80%(5/51)versus 44.83%(13/29)in the control group(P<0.05).The KPS scores in the observation group at3 months,6 months and 12 months after surgery were(91.97±4.26)points,(85.47±5.95)points,(81.92±7.32)points,respectively,which were significantly higher than corresponding(88.73±6.58)points,(81.33±4.79)points,(7.48±6.73)points in control group(all P<0.05).The average PFS and 1-year survival rate were(13.37±1.75)months and 78.43%in the observation group,which were not significantly different from(12.72±1.69)months and 75.86%in control group(P>0.05).Conclusion Compared with conventional microsurgery,MRS combined with FL-guided surgery can increase the total resection rate,protect the limb motor function,improve the quality of life in the treatment of high-grade supratentorial glioma.However,there is no evidence to suggest that this surgery can extend survival time.
作者
陈曦
CHEN Xi(Department of Neurosurgery,Zigong Fourth People's Hospital,Zigong 643000,Sichuan,CHINA)
出处
《海南医学》
CAS
2020年第14期1800-1803,共4页
Hainan Medical Journal
关键词
磁共振波谱分析
荧光素钠
导航
显微手术
幕上高级别胶质瘤
疗效
Magnetic resonance spectroscopy(MRS)
Fluorescein(FL)
Guided
Microsurgery
High-grade supratentorial glioma
Efficacy
