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目的:探讨老年人颅内肿瘤的临床特点和治疗方法。方法:本组65岁以上老年颅内肿瘤126例,分别采用手术、x刀和非手术治疗。结果:手术65例中,38例良性肿瘤肉眼或显微镜下完全切除32例,次全切除6例。27例恶性肿瘤全切除8例,次全切除10例,大部切除8例。1例囊性颅咽管瘤行立体定向穿刺内放疗。X 刀治疗32例中,肿瘤直径<3cm,行单次治疗20例;直径在3～5cm,行分次治疗12例。非手术治疗29例。结果:手术组中术后症状消失35例,改善20例,无复发7例和死亡3例。X 刀组症状消失10例,改善15例,无复发6例、死亡1例,非手术组死亡5例。结论:老年人颅内肿瘤具有以下临床特点:①术前误诊率较高,以脑血管病最多;②巨大肿瘤较多;③术前合并疾病,如高血压动脉硬化等较多;④同时多伴发有精神等症状;⑤肿瘤性质以良性多见。全身情况较好者首选手术治疗,X-刀为次选治疗方法。
Objective: To investigate the clinical features and treatment of intracranial tumors in the elderly. Methods: The group of 126 elderly patients over the age of 65 with intracranial tumors were treated with surgery, x knife and non-surgical treatment. Results: Among 65 cases of surgery, 38 cases of benign tumors were completely resected under the naked eye or under the microscope in 32 cases and subtotal resection in 6 cases. 27 cases of malignant tumor resection in 8 cases, subtotal resection in 10 cases, most of the resection in 8 cases. One case of cystic craniopharyngioma underwent stereotactic puncture radiotherapy. X knife treatment in 32 cases, the tumor diameter <3cm, a single treatment of 20 cases; diameter of 3 ~ 5cm, line treatment in 12 cases. Non-surgical treatment in 29 cases. Results: There were 35 cases of postoperative symptoms disappeared, 20 cases improved, 7 cases had no recurrence and 3 died. X knife group symptoms disappeared in 10 cases, 15 cases improved, 6 cases without recurrence, 1 case died, 5 cases died in non-operation group. Conclusion: The intracranial tumors in the elderly have the following clinical features: ① preoperative misdiagnosis rate is high, with the largest number of cerebrovascular disease; ② huge tumor; ③ preoperative preoperative diseases such as arteriosclerosis and more; ④ more Accompanied by mental symptoms; ⑤ more common benign tumor nature. Preferred body condition better surgical treatment, X-knife as the second choice treatment.