目的 观察荧光素钠引导技术在脑胶质瘤切除中的应用效果.方法 入选2013年1月—2015年6月沈阳急救中心神经外科经磁共振诊断为脑胶质瘤患者78例,拟行显微操作手术切除,根据随机数字表法分为常规手术组(38例)与荧光素钠组(40例),常规组患者采取常规显微操作切除肿瘤,荧光素钠组患者在显微操作切除肿瘤的过程中采用荧光素钠引导,根据荧光素钠将肿瘤组织染色强度来判断肿瘤边界切除肿瘤,比较2组患者手术时间及住院时间的差异、功能区与非功能区肿瘤完全切除率及患者手术前后功能状态(KPS)评分.结果 荧光素钠组患者平均手术时间、平均住院时间与常规组差异均无统计学意义[(201.9±32.6)min vs.(211.4±40.7)min,(12.7±3.1)d vs.(13.9±4.2)d,t=1.141、1.441,P>0.05].荧光素钠组患者总体肿瘤全切率(85.0%vs.55.3%)、功能区肿瘤全切率(83.3%vs.42.9%)、非功能区肿瘤全切率(85.7%vs.62.5%)均高于常规手术组,其中2组总体全切率与功能区肿瘤全切率差异有统计学意义(P<0.05),非功能区全切率比较差异无统计学意义(P>0.05).术后1个月,2组患者KPS评分均较术前显著提高(P<0.05),且荧光素钠组患者术后1个月KPS评分显著高于常规手术组[(79.8±6.3)分vs.(74.1±6.8)分,t=3.843,P<0.05].结论 荧光素钠引导脑胶质瘤显微切除手术可显著提高恶性脑胶质瘤的全切率,减少患者功能区损伤,明显提高患者术后生活质量.%Objective To observe the effect of the application of sodium fluorescein in the resection of brain glioma. Methods From January 2013 to June 2015, 78 cases of brain glioma were diagnosed by magnetic resonance imaging, and ca-ses were treated by microsurgery, according to the random number table method, they were divided into routine operation group (38 cases) and fluorescein sodium group (40 cases), and routine group were taken conventional microscopic operation resection of the tumor, sodium fluorescein was used to guide the patients in the sodium fluorescein group, according to fluores-cein sodium tumor tissue staining intensity to determine tumor margin resection of the tumor, compared operation time and hos-pitalization time difference, function and non function district complete tumor resection rate and patients before and after oper-ation function ( KPS ) score between the two groups of patients.Results Fluorescein sodium group and the conventional group's average operation time, average hospitalization time had no significant difference[(201.9 ±32.6)min vs.(211.4 ± 40.7) min,(12.7 ±3.1)d vs.(13.9 ±4.2) d;t =1.141, t =1.441, P >0.05).Fluorescein sodium group's total tumor resection rate (85.0% vs.55.3%), functional area tumor total resection rate (83.3% vs.42.9%), non functional area tumor total resection rate were higher than conventional surgery group (85.7%vs.62.5%).The two groups'overall total re-section rate and functional region tumor total resection rate difference were statistically significant ( P <0.05) and non func-tional area of the cut rate difference was not statistically significant ( P >0.05).One month after operation, KPS scores of the 2 groups were significantly increased( P <0.05) and fluorescein sodium group after 1 month's KPS score was significant-ly higher than that of conventional surgery group (79.8 ±6.3 vs.74.1 ±6.8, t =3.843, P <0.05).Conclusion Sodium fluorescein guided microsurgery can significantly improve the total resection rate of malignant glioma, reduce the functional ar-ea of patients with injury, significantly improve the quality of life of patients after surgery.
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