边缘系统胶质瘤的临床分型及显微手术治疗  

Clinical classification and microsurgical procedures for gliomas of the limbic system

作　　者：毛捷[1] 沈军[1] 钱冬喜 葛瑞祥 MAO Jie SHEN Jun QIAN Dongxi GE Ruixiang(Department of Neurosurgery,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001, China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院神经外科,安徽芜湖241001

出　　处：《皖南医学院学报》2016年第4期330-332,共3页Journal of Wannan Medical College

基　　金：安徽高校省级自然科学研究基金项目(KJ2015A141)

摘　　要：目的：探讨边缘系统胶质瘤的临床分型、显微手术技巧及患者术后并发症。方法：回顾性分析2011年12月~2015年11月我院收治的45例边缘系统胶质瘤患者的临床资料,对其临床分型、手术入路、手术切除程度及术后并发症进行总结分析。结果：肿瘤全切除33例,次全切除12例。术后病理分型：星形细胞瘤27例,胶质母细胞瘤13例,胶质肉瘤1例,少突胶质细胞瘤1例,间变型少突胶质细胞瘤2例,少突星形胶质细胞瘤1例。术后并发症：术后对侧肢体肌力下降7例,新发癫痫2例,口角歪斜1例,失语1例,肌张力低1例,皮下积液1例。术后随访1~46个月,复发17例,死亡1例。结论：边缘系统胶质瘤术后并发症较多且容易复发,根据肿瘤的分型及主体位置选择适当的手术入路尤为重要,术中尽可能切除肿瘤并将并发症控制在可控制范围以内是治疗的最佳选择,术中应注意对重要血管、神经及毗邻重要结构的保护。Objective： To investigate the clinical classification,microsurgical treatment and postoperative complications of gliomas of the limbic system.Methods： The clinical data regarding the clinical classification,surgical approach,the extent of tumor resection and postoperative complications were reviewed in 45 patients with glioma of the limbic system undergone microsurgical excision in our department between December 2011 and November 2015.Results： Tumor total resection were achieved in 33 cases,and subtotal resection in 12.Postoperative histopathological examination revealed astrocytoma in 27 cases,glioblastoma in 13,oligodendrocyte in 1,anaplastic oligodendrocyte in 2 and oligoastrocytoma in 1. Postoperative complications were associated with muscle weakness in the hemilateral extremities in 7 cases,epilepsy de novo in 2,distortion of commissure in 1,aphasia in 1,hypomyotonia in 1 and subcutaneous hydrops in 1.The follow-up in between 1 month and 46 months showed tumor recurrence in 17 cases and one death. Conclusion： The tumor relapse and postoperative complications of patients with glioma of the limbic system are frequent,and select of surgical approach according to the clinical classification and location of the tumor is significant.Removal of as much of the lesion and control the minimal complications remain the first choice whenever possible,and attention should be paid to intraoperative protection of the blood vessels and vital structures.

关 键 词：边缘系统 胶质瘤 显微手术 

分 类 号：R739.4[医药卫生—肿瘤]