单侧入路切除蝴蝶状胼胝体胶质瘤的研究

发布时间：2018-03-23 08:07

本文选题：单侧入路　切入点：蝴蝶状胼胝体胶质瘤　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:蝴蝶状胼胝体胶质瘤(肿瘤侵犯胼胝体和双侧大脑半球)的手术切除主要有双侧入路和单侧入路两种,通过比较这两种入路,探讨单侧入路切除蝴蝶状胼胝体胶质瘤的临床意义和价值。方法:收集2013年3月至2016年12月在我院神经外科住院期间诊断为蝴蝶状胼胝体胶质瘤患者42例(均行术前MRI检查诊断为胼胝体及其两侧的大脑半球占位、形似蝴蝶状、行手术切除、并术后病理诊断确诊为胶质瘤)。其中双侧额叶胼胝体胶质瘤患者29例,双侧顶叶胼胝体胶质瘤患者5例,双侧颞叶胼胝体胶质瘤患者4例,双侧侧脑室胼胝体胶质瘤患者4例。男性23例,女性19例,年龄最小14岁、最大75岁,平均年龄44.6岁。其中用双侧入路切除的患者20例,单侧入路切除的患者22例,均行术后24小时内复查CT和术后72小时内复查MRI。通过回顾性分析对比双侧入路与单侧入路的手术时间、术中出血量、肿瘤的全切率、术后并发症的发生率、平均住院天数等指标,用统计学方法处理、探讨单侧入路的临床价值。结果:用单侧入路切除的22例患者中平均手术时间为3.8±0.3小时,平均术中出血量为386±55ml,术后肿瘤全切11例,术后偏瘫1例,平均住院天数14.3±1.1天。双侧入路切除的20例患者中平均手术时间为5.3±0.5小时,平均术中出血量为534±98ml,肿瘤全切11例,术后偏瘫6例,平均住院天数24.2±3.2天。两组均无术后死亡患者。结论:单侧入路切除蝴蝶状胼胝体胶质瘤的手术时间、术中出血量、术后偏瘫的发生率、平均住院天数均低于双侧入路,两者差异有统计学意义。肿瘤切除程度两者差异无统计学意义。单侧入路切除蝴蝶状胼胝体胶质瘤更安全、有更好的治疗效果和临床价值。
[Abstract]:Objective: the surgical excision of the butterfly type corpus callosum glioma (tumor invading the corpus callosum and bilateral cerebral hemispheres) consists of bilateral approach and unilateral approach. To investigate the clinical significance and value of unilateral approach in the removal of butterfly corpus callosum glioma. Methods: 42 cases of butterfly corpus callosum glioma diagnosed in our hospital from March 2013 to December 2016 were collected. Preoperative MRI diagnosis of the corpus callosum and its bilateral cerebral hemispheres occupied, After surgical resection, 29 cases of bilateral frontal lobe corpus callosum glioma, 5 cases of bilateral parietal lobe corpus callosum glioma and 4 cases of bilateral temporal lobe corpus callosum glioma were found. There were 4 cases of bilateral ventricular corpus callosum glioma. 23 cases were male, 19 cases were female, the age was 14 years old, the maximum was 75 years old, the average age was 44.6 years, 20 cases were resected by bilateral approach and 22 cases by unilateral approach. All patients underwent CT within 24 hours after operation and MRI within 72 hours after operation. The operative time, intraoperative bleeding volume, total resection rate of tumor and the incidence of postoperative complications were retrospectively analyzed and compared between bilateral approach and unilateral approach. The clinical value of unilateral approach was studied by statistical method. Results: the mean operative time, blood loss and tumor resection were 3.8 卤0.3 hours, 386 卤55 ml and 11 cases, respectively. One case had hemiplegia, the average hospital stay was 14.3 卤1.1 days. The mean operative time, blood loss, tumor resection and postoperative hemiplegia were 5.3 卤0.5 hours, 534 卤98 ml, 11 cases and 6 cases, respectively. The average hospitalization days were 24.2 卤3.2 days. There was no postoperative death in both groups. Conclusion: the operation time, the amount of blood loss, the incidence of hemiplegia and the average hospitalization days of unilateral approach for removal of butterfly corpus callosum glioma were lower than those of bilateral approach. The difference was statistically significant. There was no significant difference in the degree of tumor resection between the two groups. Unilateral resection of butterfly corpus callosum gliomas was safer and had better therapeutic effect and clinical value.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.41

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