显微镜下肿瘤切除术联合同位素治疗脑胶质瘤的临床疗效及预后评估  

Clinical efficacy and prognosis evaluation of microsurgical tumor resection combined with isotope therapy for brain glioma

作　　者：曹廷亮 吴恒浩 张圣旭 张万宏 CAO Tingliang;WU Henghao;ZHANG Shengxu;ZHANG Wanhong(Department of Neurosurgery,Kaifeng Central Hospital,Kaifeng 475000,He’nan,China)

机构地区：[1]开封市中心医院神经外科,河南开封4750000

出　　处：《癌症进展》2024年第7期783-787,共5页Oncology Progress

基　　金：2022年度河南省医学科技攻关计划(联合共建)项目(LHGJ20220835)。

摘　　要：目的探讨显微镜下肿瘤切除术联合同位素治疗脑胶质瘤的临床疗效及预后评估。方法根据治疗方式的不同将80例脑胶质瘤手术患者分为手术组(n=37)和联合组(n=43),手术组患者接受显微镜下肿瘤切除术,联合组患者接受显微镜下肿瘤切除术联合同位素治疗,比较两组患者的临床疗效、血清学指标[血管内皮生长因子(VEGF)、胶质细胞原纤维酸性蛋白(GFAP)、β-内啡肽(β-EP)、3-硝基酪氨酸(3-NT)]、认知功能[简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)]、健康状况[卡氏功能状态(KPS)评分]、日常生活能力[日常生活能力量表(ADL)]、并发症发生情况及预后情况。结果联合组患者的临床总有效率高于手术组,复发率低于手术组,差异均有统计学意义(P﹤0.05)。术后3个月,两组患者β-EP、3-NT水平比较,差异均无统计学意义(P﹥0.05);联合组患者VEGF、GFAP水平均低于手术组,差异均有统计学意义(P﹤0.05)。术后1年,两组患者MMSE、MoCA评分比较,差异均无统计学意义(P﹥0.05);联合组患者KPS、ADL评分均高于手术组,差异均有统计学意义(P﹤0.05)。两组患者的并发症总发生率比较,差异无统计学意义(P﹥0.05)。结论显微镜下肿瘤切除术联合同位素治疗脑胶质瘤安全可靠,能够提高临床疗效,改善患者的认知功能和生活质量,并且降低并发症和复发风险。Objective To investigate the clinical efficacy and prognosis evaluation of microsurgical tumor resection combined with isotope therapy for brain glioma.Method A total of 80 patients with brain glioma undewent surgery were divided into operation group(n=37)and combined group(n=43)according to different treatment methods.The operation group received microsurgical tumor resection,and the combined group received microsurgical tumor resection combined with isotope therapy.The clinical efficacy,serum indexes[vascular endothelial growth factor(VEGF),glial fibrillary acidic protein(GFAP),β-endorphin(β-EP),3-nitrotyrosine(3-NT)],cognitive function[mini-mental state examination(MMSE),Montreal cognitive assessment scale(MoCA)],health status[Karnofsky performance status(KPS)score],ability of daily living[activity of daily living scale(ADL)],incidence of complications and prognosis were compared between two groups.Result The total clinical effective rate in the combined group was higher than that in the operation group,and the recurrence rate was lower than that in the operation group,and the differences were statistically significant(P<0.05).At three months after surgery,there were no significant differences inβ-EP and 3-NT levels between two groups(P>0.05);the levels of VEGF and GFAP in combined group were lower than those in operation group,and the differences were statistically significant(P<0.05).At one year after surgery,there were no significant differences in MMSE and MoCA scores between two groups(P>0.05);the KPS and ADL scores in combined group were higher than those in operation group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Microscopical tumor resection combined with isotope therapy for brain glioma is safe and reliable,which can improve clinical efficacy,improve patients’cognitive function and quality of life,and reduce the incidence of complications and recurrence.

关 键 词：脑胶质瘤 同位素 显微镜下肿瘤切除术 临床疗效 预后 

分 类 号：R739.41[医药卫生—肿瘤]