3D建模指导下手术治疗功能区脑胶质瘤的效果及对肿瘤全切率、并发症发生率的影响OA
Efficacy of 3D modeling-guided surgery for functional area glioma and its impact on total tumor resection rate and incidence of complications
目的 观察3D建模指导下手术治疗功能区脑胶质瘤的效果及其对肿瘤全切率、并发症发生率的影响.方法 选取2023年1月—2026年1月在长沙市第四医院和湖南省人民医院接受治疗的200例功能区脑胶质瘤患者为研究对象,根据随机数字表法分为对照组和观察组,每组100例.对照组采用常规显微镜下手术治疗,观察组在3D建模技术指导下开展手术.比较2组手术相关指标(手术时间、术中出血量、下床活动时间、肿瘤全切率)、肿瘤标志物[神经元特异性烯醇化酶(NSE)、血管内皮生长因子(VEGF)、糖类抗原153(CA153)]、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、干扰素-γ(IFN-γ)]、神经功能、日常生活活动能力及并发症发生情况.结果 200例患者均完成全部干预与随访,无脱落或缺失数据.经Bonferroni校正后,观察组手术时间短于对照组,术中出血量少于对照组,术后下床活动时间早于对照组,肿瘤全切率高于对照组,差异有统计学意义(P<0.003);观察组术后3个月美国国立卫生研究院卒中量表(NIHSS)评分低于对照组,日常生活能力量表(ADL)评分高于对照组,差异有统计学意义(P<0.003);术后7 d,2组血清NSE、VEGF、CA153水平均较术前降低,且观察组NSE、VEGF和CA153水平均低于对照组,差异有统计学意义(P<0.003).经Bonferroni校正后,术后7 d,2组血清TNF-α、IL-6、IL-1β水平均较术前降低,IFN-γ水平较术前升高,且观察组TNF-α、IL-6和IL-1β水平低于对照组,IFN-γ水平高于对照组,差异均有统计学意义(P<0.003).经Bonferroni校正后,观察组术后30 d内并发症总发生率低于对照组,差异有统计学意义(P<0.003).结论 3D建模指导下手术治疗功能区脑胶质瘤可显著优化手术相关指标,提升肿瘤全切率,有效降低术后并发症发生率,减轻炎症反应,改善神经功能与日常生活能力,为功能区脑胶质瘤的外科治疗提供更优策略.
Objective To observe the efficacy of 3D modeling-guided surgery for functional area glioma and its impact on total tumor resection rate and incidence of complications.Methods A total of 200 patients with functional area glioma who received treatment at Changsha Fourth Hospital and Hunan Provincial People's Hospital from January 2023 to January 2026 were enrolled as study sub-jects and divided into control group and observation group according to the random number table method,with 100 cases in each group.The control group underwent conventional microscope-assisted surgery,while the observation group underwent surgery under the guidance of 3D modeling technology.Surgical-related indicators(operative time,intraoperative blood loss,time to ambulation,and total tumor resectionrate),tumor markers[neuron-specific enolase(NSE),vascular endothelial growth factor(VEGF),and carbohydrate antigen 153(CA153)],inflammatory cytokines[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1 β(IL-1β),and interferon-γ(IFN-γ)],neurologi-cal function,activities of daily living,and complications were compared between the two groups.Results All 200 patients completed the entire intervention and follow-up,without dropout or miss-ing data.After Bonferroni correction,the observation group had shorter operative time,less intraop-erative blood loss,earlier postoperative time to ambulation,and a higher totaltumor resection rate compared with the control group,with statistically significant differences(P<0.003).At 3 months postoperatively,the observation group showed a lower National Institutes of Health Stroke Scale(NIHSS)score and a higher Activities of Daily Living(ADL)score than the control group,with statistically significant differences(P<0.003).At 7 days postoperatively,serum levels of NSE,VEGF,and CA153 decreased in both groups compared with preoperative levels,and the levels in the observation group were lower than those in the control group,with statistically significant differ-ences(P<0.003).After Bonferroni correction,at 7 days postoperatively,serum levels of TNF-α,IL-6,and IL-1β decreased in both groups compared with preoperative levels,while IFN-γ levels in-creased,and the observation group had lower levels of TNF-α,IL-6,and IL-1 β and a higher level of IFN-γ than the control group,with statistically significant differences(P<0.003).After Bonfer-roni correction,the total incidence of complications within 30 days postoperatively in the observation group was lower than that in the control group,with a statistically significant difference(P<0.003).Conclusion 3D modeling-guided surgery for functional area glioma can significantly opti-mize surgical-related indicators,improve total tumor resection rate,effectively reduce postoperative complication incidence,alleviate inflammatory responses,and improve neurological function and ac-tivities of daily living,thereby providing a superior strategy for the surgical treatment of functional area glioma.
文擘彬;王争;甘杰;周文;周定洲
长沙市第四医院/长沙市中西医结合医院神经外科,湖南长沙,410000长沙市第四医院/长沙市中西医结合医院神经外科,湖南长沙,410000长沙市第四医院/长沙市中西医结合医院神经外科,湖南长沙,410000长沙市第四医院/长沙市中西医结合医院神经外科,湖南长沙,410000长沙市第四医院/长沙市中西医结合医院神经外科,湖南长沙,410000
医药卫生
3D建模神经胶质瘤功能区肿瘤全切率神经元特异性烯醇化酶血管内皮生长因子炎症因子随机对照试验
3D modelinggliomafunctional areatotal tumor resection rateneuron-specific enolasevascular endothelial growth factorinflammatory factorsrandomized controlled trial
《实用临床医药杂志》 2026 (15)
28-33,6
湖南省卫生健康委科研项目计划(202204045055)
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