| Objective:Glioma is a kind of common malignant tumor of the nervous system.The tumor tissue invasive grows,and its boundary with surrounding normal tissue is unclear under the naked eyes.Surgical resection is difficult,and the prognosis of the patient is poor.Fluorescein sodium is a kind of synthetic fluorescent drug.After intravenous administration,it can accumulate in glioma tissue through the damaged blood-brain barrier and show yellow-green fluorescence under the irradiation of specific excitation light source.In glioma surgery,fluorescein sodium can help to define the tumor boundary,determine the safe margin,and guide the operation of the surgeons.The purpose of this study was to analyze different groups of glioma patients who received fluorescein-guided glioma resection or traditional glioma resection,and to compare the surgical effect,postoperative recovery and tumor recurrence rate,so as to study and discuss the clinical application effect and significance of the fluorescein-guided glioma resection.Methods:A retrospective analysis was performed on 60 glioma patients treated by Dalian central Hospital from June 2012 to November 2018.All patients underwent microsurgery surgery.30 patients of observation group received fluorescein-guided glioma resection,and 30 patients of the control group received conventional glioma resection.The composition of basic data of patients in the two groups was compared.The gender ratio,age of onset,duration of disease,clinical manifestations of first onset,location of glioma and postoperative pathological classification of patients in the two groups were counted to ensure that the difference between the two groups was not statistically significant(P>0.05).The two groups were comparable.Head CT and MRI were performed on the patients before and after the surgery.The effect of the resection of glioma in the two groups was understood through the comparison of imaging data.The duration of each patient's operation,postoperative hospitalization time and complications during treatment were recorded.All patients were assessed by KPS score before and after surgery.After discharge,patients were followed up for 3 months through outpatient department and telephone visits.Death and recurrence of glioma were recorded.The statistical software SPSS20.0 was used,the counting data were tested by X~2test,and the measurement data were tested by t test of independent samples.The results were considered statistically significant if P<0.05.Results:There are 22 total resection patients in the observation group,better than12 in the control group.And the total resection rate of glioma was 73.3%in the observation group,higher than 40.0%in the control group.Postoperative hospitalization time of the patients was 13.90±3.50 days in the observation group,less than 20.90±9.91 days in the control group.The postoperative KPS scores of patients was 20.90±9.91 points in the observation group,better than 71.33±9.00points in the control group.The follow-up results at 3 months after discharge showed that there were 3 cases of recurrence of glioma in the observation group and 12cases of recurrence in the control group.The recurrence rate of glioma in the observation group was 10.0%lower than 40%in the control group.The results were statistically significant after statistical analysis(P<0.05).The difference between the two groups was not statistically significant in terms of the difference in operation time,the incidence of various complications during hospitalization,and the death of patients followed up for 3 months after discharge(P>0.05).Conclusion:Fluorescein sodium guided microsurgery of gliomas can effectively improve the total resection rate of tumor,shorten hospitalization time,improve the postoperative KPS score,improve the recovery rate of patients,effectively reduce the glioma recurrence rate and improve patients prognosis.It is a kind of safe and effective treatment method of great significance to the clinical treatment of glioma.This method deserves to be popularized and applied. |
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