摘要
目的探讨荧光素钠神经显微手术在脑胶质瘤患者中的应用效果及其对血清S100B、神经元特异性烯醇化酶(NsE)及髓鞘碱性蛋白(MBP)水平的影响。方法选取我院收治的脑胶质瘤患者76例,采用随机数字表法分为观察组和对照组,每组38例。对照组患者行常规胶质瘤切除术,观察组患者行荧光素钠神经显微手术。比较2组患者胶质瘤切除情况、手术相关指标、手术前后脑损伤相关指标(血清S100B、NsE、MBP)、血清miRNA水平、神经功能恢复情况[长谷川智能量表(HDS)、简易精神状态量表(MMSE)、日常生活能力量表(ADL)]。随访12个月,观察2组患者生存情况。结果观察组全切率高于对照组(P<0.05),次全切率低于对照组(P<0.05)。观察组手术时间、术后下床时间、术后住院时间均短于对照组(P<0.05),术中出血量少于对照组(P<0.05)。术后6个月、12个月,观察组miR-29c水平高于对照组(P<0.05),miR-720水平低于对照组(P<0.05)。观察组术后3 d、7 d血清S100B、NsE、MBP水平低于对照组(P<0.05)。观察组术后6个月、12个月HDS、MMSE、ADL评分高于对照组(P<0.05)。随访12个月,观察组中位无进展生存期为7个月,中位生存期为11个月,对照组中位无进展生存期为6个月,中位生存期为9个月。结论荧光素钠神经显微手术能顺利切除脑胶质瘤,肿瘤全切率高,同时能减轻脑组织损伤,促进术后早期康复和神经功能的改善,且其肿瘤切除范围大,可延缓肿瘤进展,有助于延长患者无进展生存期。
Objective To investigate the effect of fluorescein sodium neuromicrosurgery in patients with glioma and its effects on serum S100B,neuron-specific enolase(NsE)and myelin basic protein(MBP)levels.Methods A total of 76 patients with glioma in our hospital were selected and divided into the observation group and the control group according to the random number table method,with 38 cases in each group.Patients in the control group underwent conventional glioma resection,while patients in the observation group underwent fluorescein sodium neuromicrosurgery.The resection of glioma,surgery-related indicators and cerebral injury related indicators(serum S100B,NsE,MBP),serum miRNA levels and neurological functional recovery hasegawa dementia scale(HDS),mini-mental state examination(MMSE),activity of daily living scale(ADL)before and after surgery of the two groups were compared.Follow up for 12 months,the survival of patients in both groups were observed.Results The total resection rate in the observation group was higher than that in the control group(P<0.05),and the subtotal resection rate was lower than that in the control group(P<0.05).The operation time,bed-leaving time and hospital stay after operation in the observation group were shorter than those in the control group(P<0.05),and the intraoperative blood loss was less than that in the control group(P<0.05).The level of miR-29c 6 and 12 months after surgery in the observation group was higher than that in the control group(P<0.05),and the level of miR-720 was lower than that in the control group(P<0.05).The levels of serum S100B,NsE and MBP 3 and 7 days after surgery in the observation group were lower than those in the control group(P<0.05).The scores of HDS,MMSE and ADL 6 and 12 months after surgery in the observation group were higher than those in the control group(P<0.05).The patients were followed up for 12 months,the median progressionfree survival period of patients in the observation group was 7 months,and the median survival period was 11 months;while the median progressionfree survival period of patients in the control group was 6 months,and the median survival period was 9 months.Conclusion Fluorescein sodium neuromicrosurgery can successfully remove glioma with a higher total tumor resection rate.It can also reduce brain tissue damage,promote early postoperative rehabilitation,and improve neurological function.And the large tumor resection range can delay tumor progression and help to prolong the progression-free survival period of patients.
作者
张川
谈晚生
王杰
ZHANG Chuan;TAN Wan-sheng;WANG Jie(Department of Neurosurgery,Huangshi Second Hospital,Huangshi Hubei 435002,China)
出处
《局解手术学杂志》
2023年第4期331-335,共5页
Journal of Regional Anatomy and Operative Surgery
基金
湖北省卫生计生西医类一般项目(WJ2015MB275)。
