视路胶质瘤的诊治分析（附8例报道并文献复习）  

Diagnosis and treatment of optic pathway glioma: report of 8 cases and review of the literature

作　　者：卢玉昭 岳建人 刘彬彬 曹成龙[2,3] 马盼 宋健 徐国政[3] LU Yu-zhao;YUE Jian-ren;LIU Bin-bin;CAO Cheng-long;MA Pan;SONG Jian;XU Guo-zheng(Medical School,Wuhan University of Science and Technology,Wuhan 430065,China;Graduate School,Southern Medical University,Guangzhou 510515,China;Department of Neurosurgery,General Hospital,Central Theater,PLA,Wuhan 430070,China)

机构地区：[1]武汉科技大学医学院,武汉430065 [2]南方医科大学研究生院,广州515510 [3]中国人民解放军中部战区总医院神经外科,武汉430070

出　　处：《中国临床神经外科杂志》2019年第12期752-754,共3页Chinese Journal of Clinical Neurosurgery

基　　金：国家自然科学基金(81571049;81400865)

摘　　要：目的探讨视路胶质瘤的诊断及治疗方法。方法回顾性分析2009~2018年收治的经病理确诊的8例视路胶质瘤的临床资料,并结合相关文献复习,总结视路胶质瘤的诊断、治疗方法。5例首发病人采取经冠状切口单侧额纵裂入路手术治疗,3例外院手术后复发病人接受伽玛刀治疗。结果5例手术中,肿瘤大部分切除4例,近全切除1例。8例中,毛细胞型星形细胞瘤7例,胶质母细胞瘤1例。2例术后视力、视野损害较术前明显改善,2例视力、视野损害同术前。3例复发病人伽玛刀治疗后6~12个月复查示肿瘤明显缩小。8例出院后随访1~3年,改良Rankin量表评分1分6例,2分2例。结论对于视路胶质瘤,多种影像技术结合可能更利于明确诊断,术中应在护视神经、下丘脑等重要结果的情况下尽量全切肿瘤。大部分视路胶质瘤,综合手术、放化疗能取得较好的效果。Objective To explore the diagnosis and treatment of optic pathway gliomas.Methods The clinical data of 8 patients with pathologically confirmed optic pathway glioma who were admitted to our hospital from 2009 to 2018 were retrospectively analyzed,and the relevant literatures were reviewed to summarize the diagnosis and treatment of optic pathway gliomas.Five patients with new diagnosed optic pathway glioma were treated by microsurgery via unilateral frontal fissure approach using a coronary incision,and 3 patients with recurrence after surgery in the other hospital received gamma knife radiosurgery.Results Of 5 patients who underwent surgery in our hospital,4 patients were mostly resected and 1 nearly totally resected.Of 8 patients,7 were pilocytic astrocytoma and 1 was glioblastoma.Visual acuity and visual field damage in 2 cases were significantly improved after surgery,and visual acuity and visual field damage in 2 cases were the same as before surgery.The following-up results(range,6~12 months)of 3 patients receiving gamma knife radiosurgery showed that the tumor volume was significantly reduced.Eight patients were followed up for 1 to 3 years after discharge.The modified Rankin scale score was 1 point in 6 patients and 2 points in 2.Conclusions The combination of multiple imaging techniques is helpful to the diagnosis of optic pathway gliomas.The tumor should be completely removed as far as possible under the conditions of no injury to the important structures such as the optic nerve and hypothalamus.For most optic pathway gliomas,comprehensive surgery combined with radiotherapy and chemotherapy can achieve better results.

关 键 词：视路胶质瘤 诊断 手术治疗 放疗 化疗 

分 类 号：R739.41[医药卫生—肿瘤] R651.11[医药卫生—临床医学]