中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2014年
9期
892-895
,共4页
陆云涛%漆松涛%潘军%方陆雄%樊俊%李志勇%邱晓瑜%刘亚伟
陸雲濤%漆鬆濤%潘軍%方陸雄%樊俊%李誌勇%邱曉瑜%劉亞偉
륙운도%칠송도%반군%방륙웅%번준%리지용%구효유%류아위
神经胶质瘤%下丘脑%神经内分泌学%生活质量%神经外科学
神經膠質瘤%下丘腦%神經內分泌學%生活質量%神經外科學
신경효질류%하구뇌%신경내분비학%생활질량%신경외과학
Glioma%Hypothalamus%Endocrinology%Quality of life%Neurosurgery
目的 探讨下丘脑胶质瘤(HG)的临床表现和影像学特点,评估手术疗效和预后.方法 回顾分析南方医院神经外科收治的36例HG患者的临床资料,并行长期随访.结果 囊实性HG多见于毛细胞型星形细胞瘤;钙化多见于星形或少突星形细胞瘤.术后早期内分泌均有不同程度下降,多轴激素缺乏和尿崩发生率,在全切除组和次全切除+部分切除组间差异无统计学意义(P =0.409和0.324).随访期7例肿瘤复发,全切除组3例均为高级别肿瘤,低于次全切除+部分切除组(P =0.022).两组生活质量差异无统计学意义(P =0.421).结论 明确HG临床和影像学特点,有助于术前诊断.手术仍为首选,全切除能降低肿瘤复发率,且未加重术后尿崩和内分泌水平改变.对下丘脑界面不清的病例,以充分减压为基础的次全切除,在减少围术期病死率的同时,能获得较好的临床效果.
目的 探討下丘腦膠質瘤(HG)的臨床錶現和影像學特點,評估手術療效和預後.方法 迴顧分析南方醫院神經外科收治的36例HG患者的臨床資料,併行長期隨訪.結果 囊實性HG多見于毛細胞型星形細胞瘤;鈣化多見于星形或少突星形細胞瘤.術後早期內分泌均有不同程度下降,多軸激素缺乏和尿崩髮生率,在全切除組和次全切除+部分切除組間差異無統計學意義(P =0.409和0.324).隨訪期7例腫瘤複髮,全切除組3例均為高級彆腫瘤,低于次全切除+部分切除組(P =0.022).兩組生活質量差異無統計學意義(P =0.421).結論 明確HG臨床和影像學特點,有助于術前診斷.手術仍為首選,全切除能降低腫瘤複髮率,且未加重術後尿崩和內分泌水平改變.對下丘腦界麵不清的病例,以充分減壓為基礎的次全切除,在減少圍術期病死率的同時,能穫得較好的臨床效果.
목적 탐토하구뇌효질류(HG)적림상표현화영상학특점,평고수술료효화예후.방법 회고분석남방의원신경외과수치적36례HG환자적림상자료,병행장기수방.결과 낭실성HG다견우모세포형성형세포류;개화다견우성형혹소돌성형세포류.술후조기내분비균유불동정도하강,다축격소결핍화뇨붕발생솔,재전절제조화차전절제+부분절제조간차이무통계학의의(P =0.409화0.324).수방기7례종류복발,전절제조3례균위고급별종류,저우차전절제+부분절제조(P =0.022).량조생활질량차이무통계학의의(P =0.421).결론 명학HG림상화영상학특점,유조우술전진단.수술잉위수선,전절제능강저종류복발솔,차미가중술후뇨붕화내분비수평개변.대하구뇌계면불청적병례,이충분감압위기출적차전절제,재감소위술기병사솔적동시,능획득교호적림상효과.
Objective To investigate the clinical manifestation and radiological features of hypothalamic glioma (HG),and to evaluate the surgical efficacy and prognosis.Methods 36 cases of HG presenting in the department of neurosurgery of Nanfang hospital were respectively analyzed.The long term follow-up was performed through recheck in outpatient department,telephone and letter.Results Solid and cystic mixed tumor was more common in pilocytic astrocytoma (PAS).However,fiber astrocytoma was predominantly solid.The calcification of tumor was more common in astrocytoma or oligodendroglioma.The postoperative endocrinological deterioration in varying degrees was found in all patients.Between GTR group and STR + PTR group,there was no significant difference of the incidence of multi-axial hormone deficiency (P =0.474) and diabetes insipidus after surgery (P =0.366).During the follow-up period,among 7 recurrence cases,three occurred in GTR group (18.7%),was slightly lower than STR + PTR group (P =0.022).Moreover,there was no difference about the quality of life of two groups (P =0.216).Conclusions It was useful to make the clinical diagnosis better with well understanding the clinical characteristics of HG.Surgical treatment remained the first choice of treatment.GTR won't deteriorate the incidence of diabetes insipidus and endocrine levels more than STR + PTR.For unclear interface and close adherence to hypothalamus,STR based on sufficient decompression reduced the perioperative incidence of death,and meanwhile obtained the satisfying clinical effects.