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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。
Objective To investigate the safety and efficacy of neuroimaging microsurgery combined with photodynamic therapy (PDT) in the treatment of functional gliomas. Methods Sixty-five patients with functional glioma were divided into two groups. Forty patients in the treatment group underwent microsurgical resection guided by nerve guidance. PDT was performed on the tumor cavity according to the structure and shape of the tumor bed. In the control group, 25 patients Simple line of nerve navigation Microsurgical removal of lesions. At the 8th week and the 12th week after the treatment, CT and MRI examination were performed to observe the changes of tumor necrosis, edema zone and residual tumor volume in the two groups and to observe the neurological deficit. Results The new neurological deficit rates of the treatment group and the control group were 2.5%, 5.0% and 7.5% and 12.0% respectively at 8 weeks and 12 weeks after treatment. Imaging showed tumor necrosis in treatment group, edema zone was alleviated in 31 cases, 8 cases of residual tumor volume was significantly reduced; control group edema zone in 15 cases, 4 cases of postoperative residual tumor volume was unchanged. Conclusions The neuronavigation microsurgery combined with PDT treatment of functional glioma can effectively inhibit the growth of the tumor, reduce the residual tumor volume and reduce the loss of neurological function, reduce the occurrence of new neurological deficits and improve the quality of life of patients Has some advantages.