神经导航显微手术联合光动力疗法治疗功能区脑胶质瘤

目的探讨神经导航显微手术联合光动力疗法（PDT）治疗功能区脑胶质瘤的安全性及有效性。方法将65例功能区胶质瘤患者分为两组,治疗组40例经神经导航指引下进行显微手术切除病灶,然后根据瘤床的结构和形状对瘤腔进行PDT治疗;对照组25例单纯行神经导航显微手术切除病灶。治疗后第8周和第12周行CT、MRI检查观察两组患者术后肿瘤坏死、水肿带减轻、残留肿瘤体积等变化,并观察神经功能缺失情况。结果治疗后8周和12周治疗组和对照组出现新的神经功能缺失率分别为2.5%、5.0%和7.5%、12.0%。影像学显示治疗组肿瘤坏死,水肿带减轻31例,8例残留肿瘤体积明显缩小;对照组水肿带减轻15例,4例术后残留肿瘤体积无变化。结论神经导航显微手术联合PDT疗法治疗功能区脑胶质瘤,能够有效抑制肿瘤生长,并能使残留肿瘤体积缩小,减少神经功能缺失,在减缓出现新的神经功能缺失和改善患者生活质量方面具有一定优势。

Neuronavigation Microsurgery Combined with Photodynamic Therapy for Functional Area Glioma

Objective To study the safety and efficiency of neuronavigation microsurgery combined with photodynamic therapy(PDT)for functional area glioma. Methods Sixty-five patients with functional area glioma were devided into,treatment group(n=25) and control group(n=25).Patiants in treatment group underwent resection of mass lesion under microscope with the guide of neuronavigation and those in control group underwent resection of mass lesion under microscope with the guide of neuronavigation but without PDT.Tumor necrosis,allevialed edema,residual tumor volume and imaging data(including CT and MRI scan) were observed 8 and 12 weeks after operation. Results The postoperative neural funetion deficit rate was 2.5% and 5.0% for the treatment group and 7.5% and 12.0% for the control group 8 and 12 weeks after operation.Imaging data showed that hydropsia area decreased in 31 patients and the residual tumor was obviously shrinked in 8 patients of treatment group.The hydropsia area decreased in 15 patients and the residual tumor did not change in 4 patients of control group. Conclusions Neuronavigation microsurgery combined with photodynamic therapy for functional area glioma can effectively inhibit tumor growth and shrink the residual tumor,and is thus advantegeous to decreasing the deficit of neural function and improving the life quality of patients.