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目的探讨毛细胞型星形细胞瘤的诊治经验。方法回顾性分析60例经病理证实的毛细胞型星形细胞瘤的临床资料,肿瘤部位:颅后窝39例(小脑蚓部9例,小脑半球29例,脑干1例),脊髓7例,幕上脑叶4例,侧脑室内4例,鞍区6例。病例均接受显微外科手术,根据病变不同部位,选择合适手术入路。结果全切除56例,部分切除4例。部分切除者术后辅助放疗或伽玛刀治疗。随访6个月~10年,全切除者均无复发,部分切除者保持稳定,肿瘤无明显增长。结论毛细胞型星形细胞瘤是最低级别胶质瘤,若能全切除病变,无需辅助治疗,效果良好,预后极佳。对于未能全切除者,辅助放疗或伽玛刀治疗,也能取得良好疗效。
Objective To investigate the diagnosis and treatment of hairy cell type astrocytoma. Methods The clinical data of 60 cases of pathologically confirmed pilocytic astrocytomas were retrospectively analyzed. The tumor sites included 39 cases of posterior fossa (9 cases of cerebellar vermis, 29 cases of cerebellar hemispheres, 1 case of brain stem), 7 cases of spinal cord , 4 cases of supratentorial lobe, 4 cases of lateral ventricle and 6 cases of sella. All patients underwent microsurgery. According to the different parts of the lesion, the appropriate surgical approach was chosen. Results Total resection in 56 cases, partial resection in 4 cases. Partial excision of postoperative adjuvant radiotherapy or gamma knife treatment. All the patients were followed up for 6 months to 10 years. No recurrence was found in the patients who underwent total resection. The patients who underwent partial resection remained stable without obvious tumor growth. Conclusion Hair cell type astrocytoma is the lowest grade gliomas, if the total removal of lesions, without adjuvant therapy, the effect is good, the prognosis is excellent. For those who did not resection, adjuvant radiotherapy or gamma knife treatment, but also get good results.