B超实时引导在低级别胶质瘤切除术中的应用  

Application value of real-time B type ultrasound guidance in resection of low-grade gliomas

作　　者：王尧 钱宝[1] 姜壮[1] 刘文波[1] 王春城[1] 王廉[1] 张成[1] Wang Yao;Qian Bao;Jiang Zhuang;Liu Wenbo;Wang Chuncheng;Wang Lian;Zhang Cheng(Department of Neurosurgery, Central Hospital of Jiamusi, Jiamusi 154002, China)

机构地区：[1]佳木斯市中心医院神经外科,黑龙江省154002

出　　处：《中华神经外科杂志》2018年第4期402-405,共4页Chinese Journal of Neurosurgery

基　　金：国家“十二五”科技支撑计划（2014BAI04B01）

摘　　要：目的 探讨B超实时引导在低级别胶质瘤切除术中的应用价值.方法 回顾性分析2012年6月至2016年6月佳木斯市中心医院神经外科收治的72例低级别胶质瘤患者的临床资料.36例行B超实时引导下肿瘤切除术（观察组）,36例行常规术前定位下肿瘤切除术（对照组）.比较两组的手术情况、肿瘤定位准确率、手术全切除率、日常生活活动能力（ADL）量表评分以及Karnofsky功能状态评分（KPS）.结果 观察组的手术时间少于对照组（P＜0.01）.观察组的肿瘤定位准确率、手术全切除率均高于对照组（均P＜0.01）.随访6个月时观察组的ADL评分较治疗前改善[分别为（84.7±8.8）分和（66.4±7.6）分,P ＜0.001],而对照组治疗前、治疗后6个月的ADL评分差异无统计学意义（P＞0.05）.随访6个月时,观察组和对照组的KPS评分[分别为（81.1±7.8）分和（71.4±9.9）分]均较治疗前[分别为（58.1±8.2）分和（56.9±9.2）分]改善（均P＜0.001）,且观察组的改善更为明显（P＜0.01）.结论 B超实时引导应用于低级别胶质瘤切除术中可获得良好的临床效果,可显著缩短手术时间,提高患者的生命质量. Objective To investigate the application value of real-time B type ultrasound guidance in resection of low-grade gliomas.Methods Seventy-two cases of patients with low-grade gliomas were selected,who were treated at Department of Neurosurgery,Central Hospital of Jiamusi from June 2012 to June 2016,and were divided into observation group （36 cases） and control group （36 cases）.Conventional tumor localization method was used in control group prior to resection,while the patients in observation group underwent tumor resection under real-time B type ultrasound guidance.The following aspects were compared between 2 groups including surgical operation,accuracy of tumor localization,total resection rate,ADL （activities of daily living） score and KPS （Karnofsky performance status） score.Results The operation time in the observation group were significantly less than that in control group （P 〈 0.01）.The accuracy of tumor localization and total resection rate in the observation group were significantly higher than those in control group （both P 〈 0.01）.At 6 months post operation,the ADL score in observation group was higher than preoperative score （84.7 ± 8.8,66.4 ± 7.6,respectively） （P 〈 0.001）,while there was no statistical difference between postoperative and preoperative score in control group （P 〉 0.05）.The 6-month follow-up showed that the patients＇ preoperative KPS scores in observation （81.1 ± 7.8） and control （71.4 ± 9.9） groups were significantly higher than postoperative scores （58.1 ± 8.2,56.9 ± 9.2,respectively） （P 〈 0.001） and the improvement in observation group was even greater （P 〈 0.01）.Conclusion Real-time B type ultrasound guidance used for low-grade gliomas resection could achieve good clinical results,significantly reduce the operation time and improve the patient＇s quality of life.

关 键 词：神经胶质瘤 神经外科手术 治疗结果 生活质量 B超实时引导 

分 类 号：R739.41[医药卫生—肿瘤]