黄石市第二医院神经外科,湖北 黄石 435002
Published:25 April 2023,
Received:29 August 2022,
扫 描 看 全 文
张川,谈晚生,王杰.荧光素钠神经显微手术在脑胶质瘤切除中的应用[J].局解手术学杂志,2023,32(04):331-334.
ZHANG Chuan,TAN Wan-sheng,WANG Jie.Application of fluorescein sodium neuromicrosurgery in glioma resection[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(04):331-334.
张川,谈晚生,王杰.荧光素钠神经显微手术在脑胶质瘤切除中的应用[J].局解手术学杂志,2023,32(04):331-334. DOI: 10.11659/jjssx.08E022157.
ZHANG Chuan,TAN Wan-sheng,WANG Jie.Application of fluorescein sodium neuromicrosurgery in glioma resection[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(04):331-334. DOI: 10.11659/jjssx.08E022157.
目的
2
探讨荧光素钠神经显微手术在脑胶质瘤患者中的应用效果及其对血清S100B、神经元特异性烯醇化酶(NsE)及髓鞘碱性蛋白(MBP)水平的影响。
方法
2
选取我院收治的脑胶质瘤患者76例,采用随机数字表法分为观察组和对照组,每组38例。对照组患者行常规胶质瘤切除术,观察组患者行荧光素钠神经显微手术。比较2组患者胶质瘤切除情况、手术相关指标、手术前后脑损伤相关指标(血清S100B、NsE、MBP)、血清miRNA水平、神经功能恢复情况[长谷川智能量表(HDS)、简易精神状态量表(MMSE)、日常生活能力量表(ADL)]。随访12个月,观察2组患者生存情况。
结果
2
观察组全切率高于对照组(
P
<
0.05),次全切率低于对照组(
P
<
0.05)。观察组手术时间、术后下床时间、术后住院时间均短于对照组(
P
<
0.05),术中出血量少于对照组(
P
<
0.05)。术后6个月、12个月,观察组miR-29c水平高于对照组(
P
<
0.05),miR-720水平低于对照组(
P
<
0.05)。观察组术后3 d、7 d血清S100B、NsE、MBP水平低于对照组(
P
<
0.05)。观察组术后6个月、12个月HDS、MMSE、ADL评分高于对照组(
P
<
0.05)。随访12个月,观察组中位无进展生存期为7个月,中位生存期为11个月,对照组中位无进展生存期为6个月,中位生存期为9个月。
结论
2
荧光素钠神经显微手术能顺利切除脑胶质瘤,肿瘤全切率高,同时能减轻脑组织损伤,促进术后早期康复和神经功能的改善,且其肿瘤切除范围大,可延缓肿瘤进展,有助于延长患者无进展生存期。
Objective
2
To investigate the effect of fluorescein sodium neuromicrosurgery in patients with glioma and its effects on serum S100B, neuron-specific enolase (NsE) and myelin basic protein (MBP) levels.
Methods
2
A total of 76 patients with glioma in our hospital were selected and divided into the observation group and the control group according to the random number table method, with 38 cases in each group. Patients in the control group underwent conventional glioma resection, while patients in the observation group underwent fluorescein sodium neuromicrosurgery. The resection of glioma, surgery-related indicators and cerebral injury related indicators (serum S100B, NsE, MBP), serum miRNA levels and neurological functional recovery [hasegawa dementia scale (HDS), mini-mental state examination (MMSE),activity of daily living scale (ADL) before and after surgery of the two groups were compared.Follow up for 12 months, the survival of patients in both groups were observed.
Results
2
The total resection rate in the observation group was higher than that in the control group (
P
<
0.05), and the subtotal resection rate was lower than that in the control group (
P
<
0.05). The operation time, bed-leaving time and hospital stay after operation in the observation group were shorter than those in the control group (
P
<
0.05), and the intraoperative blood loss was less than that in the control group (
P
<
0.05). The level of miR-29c 6 and 12 months after surgery in the observation group was higher than that in the control group (
P
<
0.05), and the level of miR-720 was lower than that in the control group (
P
<
0.05).The levels of serum S100B, NsE and MBP 3 and 7 days after surgery in the observation group were lower than those in the control group (
P
<
0.05). The scores of HDS, MMSE and ADL 6 and 12 months after surgery in the observation group were higher than those in the control group (
P
<
0.05).The patients were followed up for 12 months, the median progression-free survival period of patients in the observation group was 7 months,and the median survival period was 11 months;while the median progression-free survival period of patients in the control group was 6 months, and the median survival period was 9 months.
Conclusion
2
Fluorescein sodium neuromicrosurgery can successfully remove glioma with a higher total tumor resection rate.It can also reduce brain tissue damage,promote early postoperative rehabilitation, and improve neurological function. And the large tumor resection range can delay tumor progression and help to prolong the progression-free survival period of patients.
脑胶质瘤病情转归神经显微手术荧光素钠
gliomadisease outcomeneuromicrosurgeryfluorescein sodium
Duffau H.Brain connectomics applied to oncological neuroscience:from a traditional surgical strategy focusing on glioma topography to a meta-network approach[J].Acta Neurochir (Wien),2021,163(4):905-917.doi:10.1007/s00701-021-04752-zhttp://dx.doi.org/10.1007/s00701-021-04752-z.
Tom MC,Cahill DP,Buckner JC,et al.Management for different glioma subtypes:are all low-grade gliomas created equal?[J].Am Soc Clin Oncol Educ Book,2019,9(39):133-145.doi:10.1200/EDBK_238353http://dx.doi.org/10.1200/EDBK_238353.
Azad TD,Duffau H.Limitations of functional neuroimaging for patient selection and surgical planning in glioma surgery[J].Neurosurg Focus,2020,48(2):12-16.doi:10.3171/2019.11.FOCUS19769http://dx.doi.org/10.3171/2019.11.FOCUS19769.
凌国源.荧光素钠术中荧光辅助显微手术切除脑胶质瘤的研究进展[J].中国临床神经外科杂志,2022,27(1):56-58.doi:10.13798/j.issn.1009-153X.2022.01.021http://dx.doi.org/10.13798/j.issn.1009-153X.2022.01.021.
Faulkner H,Arnaout O,Hoshide R,et al.The surgical resection of brainstem glioma:outcomes and prognostic factors[J].World Neurosurg,2021,8(14):639-650.doi:10.1016/j.wneu.2020.10.147http://dx.doi.org/10.1016/j.wneu.2020.10.147.
刘宏志.立体定向微创手术治疗脑胶质瘤患者的临床效果及对患者Th1/Th2细胞因子的影响[J].实用癌症杂志,2020,35(11):1905-1908.doi:10.3969/j.issn.1001-5930.2020.11.043http://dx.doi.org/10.3969/j.issn.1001-5930.2020.11.043.
Saito K.Glioma surgery and surgical supporting technology[J].Neurol Surg,2021,49(3):536-548.doi:10.11477/mf.1436204427http://dx.doi.org/10.11477/mf.1436204427.
Waqas M,Shamim MS.Sodium fluorescein guided resection of malignant glioma[J].J Pak Med Assoc,2018,68(6):968-970.doi:10.1093/ons/opaa357http://dx.doi.org/10.1093/ons/opaa357.
Markosian C,Mazzola CA,Tomycz LD.Sodium fluorescein-guided gross total resection of pediatric exophytic brainstem glioma:2-dimensional operative video[J].Oper Neurosurg (Hagerstown),2021,20(2):146-147.doi:10.1093/ons/opaa357http://dx.doi.org/10.1093/ons/opaa357.
Navarro-Bonnet J,Suarez-Meade P,Brown DA,et al.Following the light in glioma surgery:a comparison of sodium fluorescein and 5-aminolevulinic acid as surgical adjuncts in glioma resection[J].J Neurosurg Sci,2019,63(6):633-647.doi:10.23736/S0390-5616.19.04745-3http://dx.doi.org/10.23736/S0390-5616.19.04745-3.
付强,图尔迪麦麦提•图尔迪艾合买提,夏鸣,等.荧光素钠“黄荧光”染色技术引导胶质母细胞瘤手术的研究[J].临床神经外科杂志,2021,18(1):47-52.doi:10.3969/j.issn.1672-7770.2021. 01.010http://dx.doi.org/10.3969/j.issn.1672-7770.2021.01.010.
夏鸣,付强,李绍山,等. 荧光素钠在术中判断胶质瘤边界的研究[J].国际神经病学神经外科学杂志,2021,48(4):354-358.doi:10.16636/j.cnki.jinn.1673-2642.2021.04.007http://dx.doi.org/10.16636/j.cnki.jinn.1673-2642.2021.04.007.
吴至武,叶新运,冯开明,等.神经导航联合荧光素钠在胶质瘤手术中的临床应用[J].重庆医学,2022,51(2):260-263.doi:10.3969/j.issn.1671-8348.2022.02.017http://dx.doi.org/10.3969/j.issn.1671-8348.2022.02.017.
Bömers JP,Danielsen ME,Schulz MK,et al.Sodium fluorescein shows high surgeon-reported usability in glioblastoma surgery[J].Surgeon,2020,18(6):344-348.doi:10.1016/j.surge.2020.01.003http://dx.doi.org/10.1016/j.surge.2020.01.003.
Xue Z,Kong L,Hao S,et al.Combined application of sodium fluorescein and neuronavigation techniques in the resection of brain gliomas[J].Front Neurol,2021,6(12):7470-7475.doi:10.3389/fneur. 2021.747072http://dx.doi.org/10.3389/fneur.2021.747072.
李月,郑燎源.脑胶质瘤患者手术前后血清S100B、髓鞘碱性蛋白、神经元特异性烯醇化酶水平变化及其临床意义[J].实用医院临床杂志,2020,17(6):119-123.doi:10.3969/j.issn.1672-6170. 2020.06.035http://dx.doi.org/10.3969/j.issn.1672-6170.2020.06.035.
努尔艾合麦提江·牙力昆,杜鹏,邓国棋,等.血清神经特异性烯醇化酶与脑胶质瘤患者术后脑损伤的相关性[J].中华实用诊断与治疗杂志,2020,34(2):163-166.doi:10.13507/j.issn.1674-3474.2020.02.017http://dx.doi.org/10.13507/j.issn.1674-3474.2020.02.017.
暴蓉,梁廷宇,侯继荣,等.血清神经元特异性烯醇化酶糖类蛋白153联合检测在脑胶质瘤诊断中的价值[J].中国药物与临床,2021,21(10):1771-1773.doi:10.11655/zgywylc2021.10.060http://dx.doi.org/10.11655/zgywylc2021.10.060.
Czeiter E,Amrein K,Gravesteijn BY,et al.Blood biomarkers on admission in acute traumatic brain injury:relations to severity,CT findings and care path in the CENTER-TBI study[J].EBioMedicine,2020,9(56):1027-1031.doi:10.1016/j.ebiom.2020.102785http://dx.doi.org/10.1016/j.ebiom.2020.102785.
Sorokina EG,Semenova ZB,Reutov VP,et al.Brain biomarkers in children after mild and severe traumatic brain injury[J].Acta Neurochir Suppl,2021,10(131):103-107.doi:10.1007/978-3-030-59436-7_22http://dx.doi.org/10.1007/978-3-030-59436-7_22.
郑盛.放射性核素和荧光素钠介导的术中导航成像技术应用基础研究[D].合肥:安徽医科大学,2018.doi:10.3969/j.issn.1671-315xhttp://dx.doi.org/10.3969/j.issn.1671-315x.
陈迪,马斯奇,吴力新,等.弥散张量成像联合荧光素钠染色在脑功能区高级别胶质瘤手术中的应用[J].中华神经外科杂志,2018,34(4):353-358.doi:10.3760/cma.j.issn.1001-2346.2018.04.007http://dx.doi.org/10.3760/cma.j.issn.1001-2346.2018.04.007.
0
Views
0
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621
