颞部星形胶质细胞瘤扩大切除方法的临床疗效研究

目的]研究颞部星形胶质细胞瘤扩大切除方法的疗效。方法]回顾性分析43例采取扩大切除术(实验组)和38例未采取扩大切除术(对照组)治疗的颞部星形胶质细胞瘤患者的临床资料。对比分析不同病理分级下不同手术方法的疗效差异。结果]Ⅰ、Ⅱ级星形胶质细胞瘤患者中,实验组的术后并发症发生率(31.03%)高于对照组(8.00%),而KPS评分(70±10)低于对照组(80±10),但是实验组的复发率(17.24%)及中位生存期(55.3月)与对照组无明显差异。而Ⅲ、Ⅳ级胶质瘤患者中,实验组的术后并发症发生率与对照组无明显差异,实验组的复发率(7.14%)低于对照组(46.15%),且KPS评分(80±10)高于对照组(70±10)。实验组的中位生存期(34.7月)高于对照组(27.8月)。结论]对于Ⅰ、Ⅱ级星形胶质细胞瘤,更积极的手术切除范围无临床意义,而对于Ⅲ、Ⅳ级星形胶质瘤患者,采取扩大切除术有利于提高患者的生存质量,降低复发率,并且延长患者的生存时间。

STUDY ON CLINICAL EFFICACY OF EXTENED RESECTION IN SURGERY OF TEMPORAL ASTROCYTOMA

Objective]To study the efficacy of extended resection method in the surgery of temporal astrocytoma.Methods]Retrospectively analysed the clinical data of 43 patients who took to expand the resection(experimental group)and 38 patients who did not take extended resection(control group).Compared the efficacy of different surgical methods in different pathological grades.Results]The incidence of postoperative complications(31.03%)of gradeⅠ,Ⅱ astrocytoma patients in the experimental group was more than control group(8.00%),and KPS score(70 ± 10)in the experimental group was more than the control group(80±10),but the recurrence rate of the experimental group(17.24%)and median survival(55.3 months)had no significant difference with the control group.And grade Ⅲ,Ⅳ patients in the experimental group,the incidence of postoperative complications had no significant difference compared with the control group,the recurrence rate of the experimental group(7.14%)was lower than the control group(46.15%),and KPS score(80±10)was higher(70 ± 10).The median survival(34.7 months)in the experimental group was more than control group(27.8 months).Conclusion]More aggressive surgical resection has no clinical significance for gradeⅠ,Ⅱ astrocytoma,and for grade Ⅲ,Ⅳ astrocytoma patients,extended resection helps improving the quality of life of patients and reducing relapse rate and prolonging survival time.