本文選題：顱腦膠質(zhì)瘤 + 術(shù)中超聲　； 參考：《新疆醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：探討術(shù)中超聲造影在顱腦膠質(zhì)瘤手術(shù)中的臨床應(yīng)用。方法：66例經(jīng)CT或MRI疑似膠質(zhì)瘤患者(最終經(jīng)病理證實(shí)收集61例),切除前經(jīng)知情同意告知患者超聲造影益處及風(fēng)險(xiǎn)并自愿選擇術(shù)中進(jìn)行超聲造影檢查的患者(實(shí)驗(yàn)組)及不愿或不能進(jìn)行超聲造影檢查的患者(對(duì)照組)。術(shù)者手持探頭,觀察腫瘤二維超聲基本特征；超聲造影檢查在行常規(guī)超聲后,觀察腫瘤超聲造影特征；術(shù)后定期采用MRI進(jìn)行判定兩組治療效果,對(duì)兩種情況下腦膠質(zhì)瘤切除殘留率以及24月內(nèi)腫瘤復(fù)發(fā)率進(jìn)行對(duì)照研究,并按照膠質(zhì)瘤級(jí)別分層后分析兩組殘留率、復(fù)發(fā)率是否存在差異。結(jié)果：(1)二維超聲顯示低、高級(jí)別的膠質(zhì)瘤的邊界、形態(tài)、壞死有統(tǒng)計(jì)學(xué)差異(P0.05)。二維超聲上低、高級(jí)別膠質(zhì)瘤的瘤周水腫無統(tǒng)計(jì)學(xué)差異(P0.05),而超聲造影兩者具有統(tǒng)計(jì)學(xué)差異(P0.05)。高級(jí)別膠質(zhì)瘤的造影達(dá)峰時(shí)間早于低級(jí)別膠質(zhì)瘤,組間比較有統(tǒng)計(jì)學(xué)差異(P0.05)。(2)膠質(zhì)瘤術(shù)后定期檢查MRI,實(shí)驗(yàn)組與對(duì)照組總體殘留率及高級(jí)別膠質(zhì)瘤殘留率比較均有統(tǒng)計(jì)學(xué)意義(χ2=7.289,P0.05；χ2=5.903,P=0.015)；而低級(jí)別膠質(zhì)瘤殘留率比較無統(tǒng)計(jì)學(xué)差異(χ2=0.873,P0.05)。術(shù)后隨訪24月內(nèi)實(shí)驗(yàn)組及對(duì)照組的總體及低級(jí)別膠質(zhì)瘤復(fù)發(fā)率比較無統(tǒng)計(jì)學(xué)差異(χ2=3.755,P0.05；χ2=0.006,P=0.939),高級(jí)別膠質(zhì)瘤復(fù)發(fā)率比較有統(tǒng)計(jì)學(xué)差異(χ2=4.521,P0.05)。結(jié)論：(1)術(shù)中常規(guī)超聲及超聲造影聯(lián)合應(yīng)用,不同級(jí)別的膠質(zhì)瘤具有不同的聲像圖特征,為膠質(zhì)瘤手術(shù)過程中初步判斷膠質(zhì)瘤級(jí)別提供較為客觀的診斷依據(jù)。(2)術(shù)中超聲造影指導(dǎo)膠質(zhì)瘤手術(shù)具有常規(guī)超聲無法比擬的優(yōu)勢(shì),尤其是對(duì)于高級(jí)別膠質(zhì)瘤,可以顯著提高治療效果,降低腫瘤殘留率及復(fù)發(fā)率,能為膠質(zhì)瘤切除術(shù)的療效判定提供客觀可靠的依據(jù)。
[Abstract]:Objective: to investigate the clinical application of intraoperative contrast-enhanced ultrasound in the operation of brain glioma. Methods Sixty-six patients suspected of glioma by CT or MRI (61 cases were confirmed by pathology, informed of the benefits and risks of contrast-enhanced ultrasound before resection and voluntarily selected for intraoperative contrast-enhanced examination) (experimental study) Group B) and patients who were unwilling or unable to perform contrast-enhanced ultrasonography (control group). The basic features of two-dimensional ultrasound were observed by using a probe held by the operator, the characteristics of ultrasound were observed after conventional ultrasound was performed, and MRI was used regularly after operation to determine the therapeutic effect of the two groups. The residual rate of glioma resection and the recurrence rate within 24 months were compared. The residual rate and recurrence rate of the two groups were analyzed according to the grade stratification of glioma. Results two dimensional ultrasound showed the boundary, morphology and necrosis of low and high grade gliomas (P 0.05). There was no significant difference in peritumoral edema between high grade gliomas and two dimensional ultrasonography (P 0.05), but there was a significant difference in contrast echocardiography between the two groups (P 0.05). The peak time of high grade gliomas was earlier than that of low grade gliomas. There was a statistical difference between the two groups (P 0.05). MRI was examined regularly after operation. There was significant difference between the experimental group and the control group in overall residual rate and high grade glioma residual rate (蠂 2 7. 289%, P 0. 05; 蠂 2 5. 903, P 0. 015, P 0. 015), but there was no significant difference in the residual rate of low grade glioma (蠂 2. 873%, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05). There was no significant difference in the overall and low grade glioma recurrence rates between the experimental group and the control group within 24 months of follow-up (蠂 2 + 3.755% P 0.05; 蠂 2 0. 006% P 0. 939). The recurrence rate of high grade gliomas was significantly different (蠂 2 4. 521% P 0 05). Conclusion conventional ultrasound and contrast-enhanced ultrasonography are used in combination with different grades of gliomas with different sonographic features. In order to provide a more objective diagnostic basis for the grade of gliomas during glioma surgery, intraoperative contrast-enhanced ultrasound has an incomparable advantage over conventional ultrasound in guiding glioma surgery, especially for high-grade gliomas. It can significantly improve the therapeutic effect, reduce the tumor residual rate and recurrence rate, and provide an objective and reliable basis for the evaluation of the curative effect of glioma resection.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R445.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前9條

1 牛朝詩,傅先明,姜曉峰,凌至培,魏祥品,魏建軍,汪業(yè)漢;神經(jīng)導(dǎo)航系統(tǒng)在腦深部病灶手術(shù)中的應(yīng)用[J];立體定向和功能性神經(jīng)外科雜志;2005年01期

2 何文;姜笑千;張懋植;王碩;趙繼宗;劉會(huì)昭;;超聲技術(shù)在腦腫瘤術(shù)中的應(yīng)用研究[J];中國超聲醫(yī)學(xué)雜志;2006年07期

3 趙玉珍;董超;劉紅磊;祝曉東;趙小華;王瑛;;肝臟良惡性腫瘤血流灌注的超聲造影定量評(píng)價(jià)[J];中國超聲醫(yī)學(xué)雜志;2007年05期

4 何文;姜笑千;王碩;張懋植;趙繼宗;劉會(huì)昭;;顱腦占位性病變的術(shù)中超聲應(yīng)用研究[J];中華醫(yī)學(xué)超聲雜志(電子版);2006年02期

5 王立淑;何文;劉會(huì)昭;林松;田永吉;;術(shù)中超聲與病理評(píng)價(jià)顱腦膠質(zhì)瘤切除程度的對(duì)照研究[J];中華醫(yī)學(xué)超聲雜志(電子版);2009年03期

6 賀焱;何文;張惠琴;;超聲造影在顱內(nèi)血管性疾病中的應(yīng)用[J];中華醫(yī)學(xué)超聲雜志(電子版);2010年03期

7 何文;姜笑千;王碩;張懋植;趙繼宗;劉會(huì)昭;;超聲造影在腦腫瘤術(shù)中的應(yīng)用[J];中華超聲影像學(xué)雜志;2006年10期

8 張忠;江濤;謝堅(jiān);;術(shù)中實(shí)時(shí)超聲在腦功能區(qū)膠質(zhì)瘤手術(shù)中的應(yīng)用價(jià)值[J];中國微侵襲神經(jīng)外科雜志;2007年11期

9 黃山;張義;;術(shù)中超聲在膠質(zhì)瘤切除術(shù)中的應(yīng)用[J];中國微侵襲神經(jīng)外科雜志;2008年01期

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