【摘要】 目的探讨应用纤维蛋白粘合剂和博莱霉素的混合剂行脑胶质瘤术中肿瘤残腔局部缓释化疗的可行性和疗效。方法选择大脑半球胶质瘤患者16例,随机分为A组8例,B组8例。两组均行开颅手术,切除肿瘤后,A组取5mg博莱霉素,B组取10mg博莱霉素,与生物胶中催化剂溶液混合后喷洒在肿瘤残腔壁上。术后12~14d、1个月、2个月复查CT,以了解局部脑组织的反应。观察记录病人术后的临床表现。结果16例术后2~14d均有明显的颅内压增高症状,复查CT证实为肿瘤残腔周围脑水肿所致,且B组水肿范围较A组重。经脱水、激素治疗后缓解。6例术后随访已达10个月,未见肿瘤复发。结论脑胶质瘤手术中肿瘤残腔喷洒生物胶博莱霉素混合剂既可对残余肿瘤进行缓释化疗,又可起到残腔止血作用,可安全应用于临床。更多还原

【Abstract】 Objective To discuss the feasible and curative effect of slow releasing chemiotherapy with mixture of fibrin adhesive and bleocin in remaining tumour cavity during operation of malignant cerebral glioma.Methods 16 cases of patients with malignant cerebral glioma were divided into two groups(A and B) at random,8 cases in each group.Mixture of 5mg bleocin and catalyst of Chinese-built biotic protein glue was sprayed in the remaining tumour cavity each patient in A group,10mg bleocin each patient in B group.CT was checked in postoperation 12～14 days,1 month,2 months later to observe on local cerebral tissue reaction.Blood routine was reexaminged in seventh day of postoperation to evaluate influence of this therapy on patients.Clinical manifestation and long-term follow-up were carried out.Results Obvious increased pressure was happened in all patients during postoperation from second to fourteenth day due to local cerebral tissue edema.The extent of edema in A group was more serious than that in B group.Edema was relieved with the help of therapy of dehydration and dexamethasone.Blood routine showed normal.The follow-up to 6 patients was made in 10 months postoperation,no tumour recurred.Conclusion The mixture playa play a role in stopping bleeding and slow releasing bleocin.Bleocin can result in cerebral edema,there is positive relationship between concentration of bleocin and extent of edema.更多还原