显微镜下全切或次全切除术在脑胶质瘤患者中的应用价值  

Application value of total or subtotal resection under microscope in patients with glioma

作　　者：张海军 曹培超 闫妍 郑占强[2] 薛长理 梁春东 郭自强 ZHANG Haijun;CAO Peichao;YAN Yan;ZHENG Zhanqiang;XUE Changli;LIANG Chundong;GUO Ziqiang(Department of Neurosurgery,Kaifeng Central Hospital,KaiFeng 475000,He’nan,China;Department of Neurosurgery,He’nan Provincial People’s Hospital,Zhengzhou 450000,He’nan,China)

机构地区：[1]开封市中心医院神经外科,河南开封475000 [2]河南省人民医院神经外科,郑州450000

出　　处：《癌症进展》2021年第22期2315-2317,2371,共4页Oncology Progress

摘　　要：目的探讨显微镜下全切或次全切除术在脑胶质瘤患者中的应用价值。方法将84例脑胶质瘤患者按照治疗方法的不同分为全切组和次全切组,每组42例。次全切组行显微镜下次全切除术,全切组行显微镜下全切术。比较两组患者手术前后的神经功能水平、认知功能水平、神经肽指标水平及并发症的发生率。结果术后6个月,两组患者美国国立卫生院神经功能缺损量表(NIHSS)评分均明显降低,且全切组患者的NIHSS评分明显低于次全切组,差异均有统计学意义(P﹤0.01)。术后6个月,两组患者简易智力状态检查量表(MMSE)中的定向力、记忆力、回忆功能、注意力与计算力、语言能力评分均明显升高,且全切组患者MMSE量表各维度评分均明显高于次全切组,差异均有统计学意义(P﹤0.01)。术后6个月,两组患者精氨酸升压素(AVP)、β-内啡肽(β-EP)、催产素(OT)水平均明显降低,神经降压素(NT)、生长抑素(SS)水平均明显升高,全切组患者AVP、β-EP、OT、NT、SS水平均明显高于次全切组,差异均有统计学意义(P﹤0.01)。次全切组的并发症总发生率为23.81%,高于全切组的4.76%,差异有统计学意义(P﹤0.05)。结论显微镜下脑胶质瘤患者的全切术治疗效果优于次全切除术,其可有效改善患者术后神经功能及认知功能水平,加快术后神经肽水平的恢复,且并发症发生率较低。Objective To explore the application value of total or subtotal resection under microscope in patients with glioma.Method A total of 84 patients with glioma were divided into the total resection group(n=42,received total resection under microscope)and subtotal resection group(n=42,received subtotal resection under microscope).The lev-els of neurological function,cognitive function,neuropeptide index and the incidence of complications were compared be-tween the two groups of patients before and after surgery.Result After surgery 6 months,the scores of National Institute of Health stroke scale(NIHSS)of the two groups decreased,and the scores of NIHSS in the total resection group was sig-nificantly lower than that in the subtotal resection group,the differences were statistically significant(P<0.01).After sur-gery 6 months,the scores of orientation,memory,recall function,attention and calculation ability,and language ability of mini-mental state examination(MMSE)of the two groups increased,and the each dimension score of MMSE in total re-section group were significantly higher scores than those of subtotal resection group(P<0.01).After surgery 6 months,the levels of arginine vasopressin(AVP),β-endorphin(β-EP)and oxytocin(OT)in the two groups decreased,the levels of neurotensin(NT)and somatostatin(SS)in the two groups increased,but the levels of AVP,β-EP,OT,NT and SS in the to-tal resection group were significantly higher than those in the subtotal resection group(P<0.01).The incidence of com-plications in the subtotal resection group was 23.81%,higher than that in the total resection group of 4.76%(P<0.05).Conclusion Total resection under microscope is better than the subtotal resection,which can effectively improve the postoperative neurological function and cognitive function,strengthen the recovery of neuropeptide levels and reduce the complications.

关 键 词：脑胶质瘤 全切术 次全切除术 认知功能 

分 类 号：R739.41[医药卫生—肿瘤]