摘要
目的探讨荧光素钠引导对间变性胶质瘤手术切除程度的影响。方法对13例荧光素钠引导下进行显微外科手术切除的间变性胶质瘤患者的临床资料进行回顾性分析。患者在全身麻醉诱导后经静脉注射1～2mg/kg荧光素钠,在Yellow 560专用滤波器的荧光模式下观察并切除肿瘤。通过术前与术后磁共振成像(MRI)对比评估患者肿瘤切除程度。结果除一过性皮肤和尿液黄染外,静脉注射荧光素钠后患者未发生过敏反应及其他不良反应。在专用荧光滤波器下观察,肿瘤组织均呈明亮的黄色荧光,而正常脑组织不发光,荧光素钠引导有助于术中判定肿瘤边界。手术前后MRI对比显示,11例获得肿瘤全切,手术全切率为84.6%。结论小剂量荧光素钠荧光有助于术中清晰辨认间变性胶质瘤的边界,可作为提高胶质瘤全切率的术中辅助措施。
Objective To investigate the effect of fluorescein sodium guided surgery on resection extent of anaplastic glioma.Methods The clinical data of 13 cases of patients with anaplastic glioma who underwent fluorescein sodium guided resection of tumors were retrospectively analyzed.After general anesthesia induction,all patients were intravenously injected fluorescein sodium at a dose of 1-2 mg/kg.The tumor was identified and resected under the Yellow 560 special filter after opening the dura.The preoperative and postoperative MRI were compared,and the extent of tumor resection was evaluated.Results Except for transient yellow discoloration of skin and urine,no anaphylactic reaction or other obvious adverse effect was observed after intravenous administration of low dose fluorescein sodium.Under the dedicated fluorescence filter,the tumor tissue markedly demonstrated yellow fluorescence,while no fluorescence was observed in normal brain tissue,thereby clearly demarcated the tumor margin intraoperatively.By comparing the preoperative and postoperative MRI,11 cases(84.6%)of patients achieved total tumor resection.Conclusion Low dose fluorescein sodium may facilitate clear identification of border of the anaplastic glioma,and become an practical adjuvant procedure to improve the total resection rate of glioma.
作者
范存刚
蒋亦林
刘如恩
许可
武广永
周景儒
刘波
FAN Cungang;JIANG Yilin;LIU Ruen;XU Ke;WU Guangyong;ZHOU Jingru;LIU Bo(Department of Neurosurgery,Peking University People′s Hospital,Beijing 100044,China)
出处
《重庆医学》
CAS
2019年第7期1114-1117,共4页
Chongqing medicine
基金
国家自然科学基金资助项目(81001009)
北京大学人民医院研究与发展基金(RDC 2015-05
RDE 2018-07)
关键词
神经胶质瘤
荧光素钠
荧光引导手术
全切除
glioma
fluorescein sodium
fluorescence-guided surgery
gross total resection
