中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2014年
7期
674-676
,共3页
韩波%刘东康%孔德生%杨俊%徐宇伦%王劲%王贵怀
韓波%劉東康%孔德生%楊俊%徐宇倫%王勁%王貴懷
한파%류동강%공덕생%양준%서우륜%왕경%왕귀부
胶质母细胞瘤%脊髓%原发性%外科治疗%预后
膠質母細胞瘤%脊髓%原髮性%外科治療%預後
효질모세포류%척수%원발성%외과치료%예후
Glioblastoma%Spinal cord%Primary%Surgical management%Prognosis
目的 探讨原发性脊髓胶质母细胞瘤的外科治疗方法及预后.方法 回顾性分析经外科手术治疗的15例原发性脊髓胶质母细胞瘤患者的临床资料.结果 15例患者中,大部分切除5例,部分切除10例.14例患者术后采用放疗和(或)化疗.经随访,所有患者均死亡,死因明确者11例,其中3例死于术后并发症,8例死于脊髓及脑转移.整体患者中位生存时间为11个月,大部切除组与部分切除组患者中位生存时间分别为为12个月与11个月.应用Log-rank检验得出两组之间生存率差异无统计学意义(P>0.05).结论 原发性脊髓胶质母细胞瘤为高侵袭性及高度恶性疾病,临床罕见,易复发和转移,预后极差;手术的目的是明确病理诊断,减少肿瘤负荷,改善压迫症状.术后联合放疗、化疗等综合措施以提高患者的生存质量和延长生存期.
目的 探討原髮性脊髓膠質母細胞瘤的外科治療方法及預後.方法 迴顧性分析經外科手術治療的15例原髮性脊髓膠質母細胞瘤患者的臨床資料.結果 15例患者中,大部分切除5例,部分切除10例.14例患者術後採用放療和(或)化療.經隨訪,所有患者均死亡,死因明確者11例,其中3例死于術後併髮癥,8例死于脊髓及腦轉移.整體患者中位生存時間為11箇月,大部切除組與部分切除組患者中位生存時間分彆為為12箇月與11箇月.應用Log-rank檢驗得齣兩組之間生存率差異無統計學意義(P>0.05).結論 原髮性脊髓膠質母細胞瘤為高侵襲性及高度噁性疾病,臨床罕見,易複髮和轉移,預後極差;手術的目的是明確病理診斷,減少腫瘤負荷,改善壓迫癥狀.術後聯閤放療、化療等綜閤措施以提高患者的生存質量和延長生存期.
목적 탐토원발성척수효질모세포류적외과치료방법급예후.방법 회고성분석경외과수술치료적15례원발성척수효질모세포류환자적림상자료.결과 15례환자중,대부분절제5례,부분절제10례.14례환자술후채용방료화(혹)화료.경수방,소유환자균사망,사인명학자11례,기중3례사우술후병발증,8례사우척수급뇌전이.정체환자중위생존시간위11개월,대부절제조여부분절제조환자중위생존시간분별위위12개월여11개월.응용Log-rank검험득출량조지간생존솔차이무통계학의의(P>0.05).결론 원발성척수효질모세포류위고침습성급고도악성질병,림상한견,역복발화전이,예후겁차;수술적목적시명학병리진단,감소종류부하,개선압박증상.술후연합방료、화료등종합조시이제고환자적생존질량화연장생존기.
Objective To explore the microsurgical management and prognosis of primary intramedullary glioblastoma.Methods The clinical datas of 15 patients with primary intramedullary glioblastoma who accepted microsurgical treatment were analyzed retrospectively.Results Mostly resection was performed in 5 cases,and partial resection in 10.14 patients were treated with postoperative radiotherapy and/or chemotherapy.All patients died during the follow-up period.3 of 11 cases with clear cause of death died of postoperative complications,8 cases died of spinal cord and brain metastases.By Kaplan-Meier analysis,the median survival for all patients,Mostly resection subgroup and partial resection subgroup was 11 months,12 months and 11 months,respectively.The difference in the survival duration between mostly and partial resection did not reach statistical significance (P > 0.05).Conclusions Primary spinal glioblastoma is a rare disease,with an aggressive course and poor prognosis.The purpose of operation is to confirm the pathologic diagnosis,reduce tumor burden,and relieve the symptoms.An aggressive comprehensive treatment (such as postoperative radiotherapy,chemotherapy protocols) should be performed to extend the patient's survival duration with better quality of life.