本文選題：單側(cè)入路　切入點(diǎn)：蝴蝶狀胼胝體膠質(zhì)瘤　出處：《新疆醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:蝴蝶狀胼胝體膠質(zhì)瘤(腫瘤侵犯胼胝體和雙側(cè)大腦半球)的手術(shù)切除主要有雙側(cè)入路和單側(cè)入路兩種,通過比較這兩種入路,探討單側(cè)入路切除蝴蝶狀胼胝體膠質(zhì)瘤的臨床意義和價(jià)值。方法:收集2013年3月至2016年12月在我院神經(jīng)外科住院期間診斷為蝴蝶狀胼胝體膠質(zhì)瘤患者42例(均行術(shù)前MRI檢查診斷為胼胝體及其兩側(cè)的大腦半球占位、形似蝴蝶狀、行手術(shù)切除、并術(shù)后病理診斷確診為膠質(zhì)瘤)。其中雙側(cè)額葉胼胝體膠質(zhì)瘤患者29例,雙側(cè)頂葉胼胝體膠質(zhì)瘤患者5例,雙側(cè)顳葉胼胝體膠質(zhì)瘤患者4例,雙側(cè)側(cè)腦室胼胝體膠質(zhì)瘤患者4例。男性23例,女性19例,年齡最小14歲、最大75歲,平均年齡44.6歲。其中用雙側(cè)入路切除的患者20例,單側(cè)入路切除的患者22例,均行術(shù)后24小時(shí)內(nèi)復(fù)查CT和術(shù)后72小時(shí)內(nèi)復(fù)查MRI。通過回顧性分析對比雙側(cè)入路與單側(cè)入路的手術(shù)時(shí)間、術(shù)中出血量、腫瘤的全切率、術(shù)后并發(fā)癥的發(fā)生率、平均住院天數(shù)等指標(biāo),用統(tǒng)計(jì)學(xué)方法處理、探討單側(cè)入路的臨床價(jià)值。結(jié)果:用單側(cè)入路切除的22例患者中平均手術(shù)時(shí)間為3.8±0.3小時(shí),平均術(shù)中出血量為386±55ml,術(shù)后腫瘤全切11例,術(shù)后偏癱1例,平均住院天數(shù)14.3±1.1天。雙側(cè)入路切除的20例患者中平均手術(shù)時(shí)間為5.3±0.5小時(shí),平均術(shù)中出血量為534±98ml,腫瘤全切11例,術(shù)后偏癱6例,平均住院天數(shù)24.2±3.2天。兩組均無術(shù)后死亡患者。結(jié)論:單側(cè)入路切除蝴蝶狀胼胝體膠質(zhì)瘤的手術(shù)時(shí)間、術(shù)中出血量、術(shù)后偏癱的發(fā)生率、平均住院天數(shù)均低于雙側(cè)入路,兩者差異有統(tǒng)計(jì)學(xué)意義。腫瘤切除程度兩者差異無統(tǒng)計(jì)學(xué)意義。單側(cè)入路切除蝴蝶狀胼胝體膠質(zhì)瘤更安全、有更好的治療效果和臨床價(jià)值。
[Abstract]:Objective: the surgical excision of the butterfly type corpus callosum glioma (tumor invading the corpus callosum and bilateral cerebral hemispheres) consists of bilateral approach and unilateral approach. To investigate the clinical significance and value of unilateral approach in the removal of butterfly corpus callosum glioma. Methods: 42 cases of butterfly corpus callosum glioma diagnosed in our hospital from March 2013 to December 2016 were collected. Preoperative MRI diagnosis of the corpus callosum and its bilateral cerebral hemispheres occupied, After surgical resection, 29 cases of bilateral frontal lobe corpus callosum glioma, 5 cases of bilateral parietal lobe corpus callosum glioma and 4 cases of bilateral temporal lobe corpus callosum glioma were found. There were 4 cases of bilateral ventricular corpus callosum glioma. 23 cases were male, 19 cases were female, the age was 14 years old, the maximum was 75 years old, the average age was 44.6 years, 20 cases were resected by bilateral approach and 22 cases by unilateral approach. All patients underwent CT within 24 hours after operation and MRI within 72 hours after operation. The operative time, intraoperative bleeding volume, total resection rate of tumor and the incidence of postoperative complications were retrospectively analyzed and compared between bilateral approach and unilateral approach. The clinical value of unilateral approach was studied by statistical method. Results: the mean operative time, blood loss and tumor resection were 3.8 鹵0.3 hours, 386 鹵55 ml and 11 cases, respectively. One case had hemiplegia, the average hospital stay was 14.3 鹵1.1 days. The mean operative time, blood loss, tumor resection and postoperative hemiplegia were 5.3 鹵0.5 hours, 534 鹵98 ml, 11 cases and 6 cases, respectively. The average hospitalization days were 24.2 鹵3.2 days. There was no postoperative death in both groups. Conclusion: the operation time, the amount of blood loss, the incidence of hemiplegia and the average hospitalization days of unilateral approach for removal of butterfly corpus callosum glioma were lower than those of bilateral approach. The difference was statistically significant. There was no significant difference in the degree of tumor resection between the two groups. Unilateral resection of butterfly corpus callosum gliomas was safer and had better therapeutic effect and clinical value.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R739.41

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本文編號(hào)：1652603