[1]窦志金,袁波,段勇刚.岛叶高级别胶质瘤的手术疗效分析[J].中国临床神经外科杂志,2022,27(07):558-560.[doi:10.13798/j.issn.1009-153X.2022.07.009]
　DOU Zhi-jin,YUAN Bo,DUAN Yong-gang.Clinical efficacy of surgical resection for high-grade gliomas in the insular lobe[J].,2022,27(07):558-560.[doi:10.13798/j.issn.1009-153X.2022.07.009]
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岛叶高级别胶质瘤的手术疗效分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
27
期数:
2022年07期
页码:
558-560
栏目:
论著
出版日期:
2022-07-31

文章信息/Info

Title:
Clinical efficacy of surgical resection for high-grade gliomas in the insular lobe
文章编号:
1009-153X(2022)07-0558-03
作者:
窦志金; 袁波; 段勇刚
462000 河南，漯河市中心医院神经外科（窦志金、袁波、段勇刚）
Author(s):
DOU Zhi-jin;  YUAN Bo;  DUAN Yong-gang
Department of Neurosurgery, Luohe Central Hospital, Luohe 462000, China
关键词:
颅内肿瘤; 岛叶胶质瘤; 高级别胶质瘤; 显微手术; 疗效
Keywords:
Glioma;  Insular glioma;  High-grade glioma;  Microsurgery;  Clinical efficacy
分类号:
R739.41;R651.1+1
DOI:
10.13798/j.issn.1009-153X.2022.07.009
文献标志码:
A
摘要:
目的 探讨显微手术治疗岛叶高级别胶质瘤（HGG）的疗效。方法 回顾性分析2015~2020年显微手术治疗的37例岛叶HGG的临床资料。结果 26例采用术中唤醒麻醉技术，11例应用术中监护，5例采用术中唤醒麻醉+术中监护，10例使用5-氨基乙酰丙酸荧光引导。肿瘤全切除5例，肿瘤次全切除32例。术后病理显示多形性胶质母细胞瘤11例，间变性星形细胞瘤21例，间变性少突胶质细胞瘤5例。术后出现缺血性脑卒中3例，脑积水1例，持续性非缺血性左侧肢体轻度无力1例，短暂神经系统症状3例。术后随访4.0~40.5个月，中位数17.0个月。21例（56.76%）出现肿瘤复发/进展，中位进展时间为15.0个月（4.0~38.0个月），其中8例在影像学证据显示进展前有癫痫复发。7例死亡，其中6例死于肿瘤进展，1例术后4个月死于肺动脉栓塞。随访期间，27例（72.97%）无癫痫发作，为Engel分级ⅠA级；10例（27.03%）有癫痫发作。结论 手术联合辅助技术对岛叶HGG进行最大程度地安全切除是可实现的，并且有良好的癫痫发作控制率；然而，这种益处应该与永久性神经功能缺损的风险进行权衡。对于伴癫痫发作并接受手术切除的岛叶HGG，癫痫发作结局是一个重要的衡量指标。
Abstract:
Objective To investigate the clinical efficacy of microsurgery for the patients with insular high-grade glioma (HGG). Methods The clinical data of 37 patients with insular HGG who underwent microsurgery from 2015 to 2020 were retrospectively analyzed. Results Twenty-six patients received intraoperative wake-up anesthesia, 11 received intraoperative monitoring, 5 received intraoperative wake-up anesthesia and intraoperative monitoring, and 10 received 5-aminolevulinic acid fluorescence guidance. Total tumor resection was achieved in 5 patients and subtotal in 32. Postoperative pathological examination showed glioblastoma multiforme in 11 patients, anaplastic astrocytoma in 21, and anaplastic oligodendroglioma in 5. Ischemic stroke ocurred in 3 patients, hydrocephalus in 1, persistent non-ischemic left limb weakness in 1, and transient neurological symptoms in 3. Postoperative follow-up ranged from 4.0 months to 40.5 months, with a median of 17.0 months. Tumor recurrence/progression occurred in 21 patients (56.76%), of whom 8 patients had epilepsy recurrence before imaging evidence showing progression. Seven patients died, including six due to tumor progression and one due to pulmonary embolism 4 months after surgery. During the follow-up, 27 patients (72.97%) had no seizures (Engel class IA) and 10 (27.03%) had epileptic seizures. Conclusions Surgery combined with adjuvant techniques for maximally safe resection of insular HGG is achievable with good rates of seizure control; however, this benefit should be weighed against the risk of permanent neurological deficit. Seizure outcome is an important index of insular HGG with seizures undergoing surgical resection.

参考文献/References:

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备注/Memo

备注/Memo:
（2022-05-12收稿，2022-06-25修回）
通讯作者:袁　波，E-mail：yblhszxyy@163.com
更新日期/Last Update: 2022-08-31