摘要
目的观察立体定向微创手术(SRS)对脑胶质瘤患者的临床疗效。方法选取南阳市第一人民医院2023年1月至2024年6月期间收治的120例脑胶质瘤患者开展前瞻性对照研究,通过计算机分组法生成随机序列后,将入组患者分为常规组和微创组,每组60例。常规组实施传统开颅胶质瘤切除术治疗,微创组实施SRS治疗,术后随访半年,比较两组患者的临床指标,血脑屏障功能(BBB),神经功能及并发症发生情况。结果结果显示,微创组的手术时间、麻醉时间、术中出血量、ICU停留时间、下床活动时间、住院时间均低于常规组(t=14.227,16.935,43.983,12.804,16.160,4.789;P<0.05)。微创组的基质金属蛋白酶9(MMP9)低于常规组,紧密连接蛋白Occludin(OCLN)、Zonulaoccludens1(ZO-1)、胶原蛋白Ⅳ(CTⅣ)均高于常规组(t=3.486,2.710,3.152,3.434;P<0.05)。微创组的胶质纤维酸性蛋白(GFAP)、神经元特异性烯醇化酶(NSE)、神经丝轻链蛋白(NF-L)、S100钙结合蛋白β(S100β)均低于常规组(t=15.257,3.423,3.533,2.578;P<0.05)。截至随访结束,微创组的并发症发生率为8.33%(5/60)低于常规组23.33%(14/60)(χ^(2)=5.065;P<0.05)。结论SRS能提高脑胶质瘤患者的手术效率,并加快患者术后康复进程,可有效减轻BBB损伤及神经功能损伤,显著降低并发症发生率。
Objective To observe the application effect of Stereotactic Radiosurgery(SRS)on patients with glioma.Methods A prospective clinical controlled trial was conducted on 120 patients with glioma in our hospital from January 2023 to June 2024.After generating random sequence by computer grouping method,the patients were divided into conventional group and minimally invasive group,with 60 cases in each group.The conventional group received conventional craniotomy for glioma resection,and the minimally invasive group received SRS treatment.The patients were followed-up for half a year.The clinical indicators,blood-brain-barrier function,neurological function and complications of the two groups were compared.Results Under different treatment schemes,the operation time,anesthesia time,intraoperative blood loss,ICU stay time,ambulation time and hospitalization time of the minimally invasive group were lower than those of the conventional group(t=14.227,16.935,43.983,12.804,16.160,4.789;P<0.05).The MMP9 in the minimally invasive group was lower than that in the conventional group,Occludin(OCLN),Zonula Occludens1(ZO-1),CTⅣwas higher than that of the conventional group(t=3.486,2.710,3.152,3.434;P<0.05).The levels of GFAP,NSE,NF-L and S100βin the minimally invasive group were lower than those in the conventional group(t=15.257,3.423,3.533,2.578;P<0.05).By the end of follow-up,the incidence of complications in the minimally invasive group was 8.33%(5/60),which was lower than 23.33%(14/60)in the conventional group(χ^(2)=5.065;P<0.05).Conclusion SRS can improve the operation efficiency of patients with glioma,and accelerate the postoperative rehabilitation process of patients,which can effectively reduce blood-brain-barrier injury and nerve function injury,and also has a positive impact on reducing the risk of complications.
作者
寇安玉
孙宁
李东
Kou Anyu;Sun Ning;Li Dong(Department of Operating,The First People’s Hospital of Nanyang,Nanyang,Henan 473000,China)
出处
《青岛医药卫生》
2025年第4期283-287,共5页
Qingdao Medical Journal
基金
河南省医学科技攻关项目(LHGJ20201021026)。
关键词
脑胶质瘤
立体定向微创手术
血脑屏障
神经功能
并发症
glioma
stereotactic minimally invasive surgery
blood brain barrier
neurological function
complications
作者简介
通讯作者:寇安玉,邮箱:kouannyu3d@sina.com。
