立体定向穿刺引流结合伽玛刀治疗囊性脑转移瘤的疗效及预后  

Therapeutic effect and prognosis of stereotactic puncture and drainage combined with gamma knife in the treatment of cystic brain metastases

作　　者：郑宏伟 冯文 陈昌平 张桓 王嗣嵩 任骥 Zheng Hongwei;Feng Wen;Chen Changping;Zhang Huan;Wang Sisong;Ren Ji(Department of Neurosurgery,Chengdu 363 Hospital,Chengdu 610041,China)

机构地区：[1]四川成都市三六三医院神经外科,610041

出　　处：《中国临床保健杂志》2019年第3期396-398,共3页Chinese Journal of Clinical Healthcare

基　　金：四川省科技计划项目(2014FZ0047)

摘　　要：目的评价立体定向穿刺引流结合伽玛刀治疗囊性脑转移瘤的临床效果以及预后,寻求更高效的治疗方案。方法选取脑转移瘤患者94例为研究对象,按照随机数字表法分为两组,分析两组原发病灶数、类型和位置差异是否有统计学意义。研究组使用立体定向穿刺引流+伽玛刀疗法,对照组使用立体定向穿刺引流疗法,记录两组对神经症状和体征的治疗缓释率。随访2年,记录两组中位生存时间和6个月、1年、2年生存率。结果研究组总缓解率85. 11%,高于对照组的63. 83%,差异有统计学意义(P <0. 05)。研究组患者的中位生存时间及6个月、1年、2年存活率分别为13. 6个月、82. 98%、57. 45%及23. 40%,对照组患者的中位生存时间及6个月、1年、2年存活率分别为7. 3个月、63. 83%、36. 17%及8. 51%。两组存活率比较,P <0. 05。结论立体定向穿刺引流结合伽玛刀治疗囊性脑转移瘤可以快速缓解颅内压,减轻颅内负荷,提高患者的2年存活率,增加存活时间,而且有效缓解神经症状和体征,提高生活质量。Objective To evaluate the therapy and prognosis effects of stereotactic puncture and drainage combined with gamma knife in the treatment of cystic brain metastases.Methods Ninety-four patients with brain metastases were selected as the research subjects.Clinical data were collected and randomly divided into two groups.The number,type and location of primary lesions in the two groups were analyzed.Stereotactic puncture drainage plus gamma knife therapy was used in the study group and stereotactic puncture drainage therapy was used in the control group.The treatment of neurological symptoms and signs in the two groups was recorded.Sustained release rate was followed up for three years.Median survival time and survival rates of 6 months,1 year and 2 years were recorded.Result The total remission rate was 85.11% in the study group and 63.83% in the control group.The difference was statistically significant (P<0.05).The median survival time and 6-month,1-year and 2-year survival rates in the study group were 13.6 months,82.98%,57.45% and 23.40%,respectively.The median survival time and 6-month,1-year and 2-year survival rates in the control group were 7.3 months,63.83%,36.17% and 8.51%,comparison of the survival rate (%) of two groups,P<0.05.Conclusion Stereotactic puncture and drainage combined with gamma knife treatment of cystic brain metastases can quickly relieve intracranial pressure,reduce intracranial load,improve the 2-year survival rate of patients,increase survival time and effectively alleviate neurological symptoms and signs and improve the quality of lif.

关 键 词：脑肿瘤 放射外科手术 立体定位技术 存活率 预后 

分 类 号：R739.4[医药卫生—肿瘤]