中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2010年
7期
592-595
,共4页
廖晓灵%黄光富%刘进平%张冠妮
廖曉靈%黃光富%劉進平%張冠妮
료효령%황광부%류진평%장관니
神经导航%电生理监测%功能区%脑肿瘤
神經導航%電生理鑑測%功能區%腦腫瘤
신경도항%전생리감측%공능구%뇌종류
Neuronavigation%Electrophysiological monitoring%Functional area%Brain neoplasms
目的 探讨脑功能区肿瘤治疗的策略和技巧.方法 分析2008年5月至2009年5月手术治疗的脑功能区41例肿瘤.使用神经导航和神经电生理辅助的有23例(辅助组),未使用18例(未辅助组).未辅助组直接行显微手术切除肿瘤.辅助组采用神经导航、皮层神经电刺激(MEP)、体感诱发电位(SEP)、术中唤醒麻醉等技术确定肿瘤和脑功能区,根据肿瘤和功能区的关系切除肿瘤.结果 未辅助组肿瘤全切4例(22%),3例(17%)次全切,11例(61%)大部切除.术后功能良好6例(33%),无变化2例(11%),10例(56%)功能障碍加重.辅助组肿瘤全切12例(52%),4例(17%)次全切,7例(31%)大部切除.术后功能良好16例(70%),无变化3例(13%),4例(17%)功能障碍加重.两组肿瘤全切率及术后功能障碍发生率差异有统计学意义(P<0.05).结论 在神经导航和神经电生理监测的辅助下,可以做到精确的病灶解剖和脑功能区定位,加上运用娴熟的显微手术技巧,脑功能区的肿瘤也能取得良好疗效.
目的 探討腦功能區腫瘤治療的策略和技巧.方法 分析2008年5月至2009年5月手術治療的腦功能區41例腫瘤.使用神經導航和神經電生理輔助的有23例(輔助組),未使用18例(未輔助組).未輔助組直接行顯微手術切除腫瘤.輔助組採用神經導航、皮層神經電刺激(MEP)、體感誘髮電位(SEP)、術中喚醒痳醉等技術確定腫瘤和腦功能區,根據腫瘤和功能區的關繫切除腫瘤.結果 未輔助組腫瘤全切4例(22%),3例(17%)次全切,11例(61%)大部切除.術後功能良好6例(33%),無變化2例(11%),10例(56%)功能障礙加重.輔助組腫瘤全切12例(52%),4例(17%)次全切,7例(31%)大部切除.術後功能良好16例(70%),無變化3例(13%),4例(17%)功能障礙加重.兩組腫瘤全切率及術後功能障礙髮生率差異有統計學意義(P<0.05).結論 在神經導航和神經電生理鑑測的輔助下,可以做到精確的病竈解剖和腦功能區定位,加上運用嫻熟的顯微手術技巧,腦功能區的腫瘤也能取得良好療效.
목적 탐토뇌공능구종류치료적책략화기교.방법 분석2008년5월지2009년5월수술치료적뇌공능구41례종류.사용신경도항화신경전생리보조적유23례(보조조),미사용18례(미보조조).미보조조직접행현미수술절제종류.보조조채용신경도항、피층신경전자격(MEP)、체감유발전위(SEP)、술중환성마취등기술학정종류화뇌공능구,근거종류화공능구적관계절제종류.결과 미보조조종류전절4례(22%),3례(17%)차전절,11례(61%)대부절제.술후공능량호6례(33%),무변화2례(11%),10례(56%)공능장애가중.보조조종류전절12례(52%),4례(17%)차전절,7례(31%)대부절제.술후공능량호16례(70%),무변화3례(13%),4례(17%)공능장애가중.량조종류전절솔급술후공능장애발생솔차이유통계학의의(P<0.05).결론 재신경도항화신경전생리감측적보조하,가이주도정학적병조해부화뇌공능구정위,가상운용한숙적현미수술기교,뇌공능구적종류야능취득량호료효.
Objective Explore the strategy and skills of tumor resection in functional areas. Method From May 2008 to May 2009,41 cases were studied,among which 23 cases were operated and assisted with neuronavigation and electrophysiological monitoring, 18 cases were treated solely by microsurgery. In navigation group, tomors and functional areas were located by neuronavigation, somatosensory evoked potential( SEP) ,motor evoked potential( MEP) and awake surgery techniques, then removal of tumor was achievedc according to the relationship between tumors and functional areas. Results In no - assisted group,4 tumors (22%) were totally removed, 3 ( 17% ) subtotal removed, 11 (61% ) partialy removed. 6 cases ( 33% ) had good recovery, 2 ( 11% ) no changed, 10 ( 56% ) impaired. In navigation group, 12 tumors ( 52% ) were totally removed, 4 ( 17% ) subtotal removed, 7 (31%) partialy removed. 16 cases ( 70% ) had good recovery, 3 ( 13% ) no changed, 4 (17%) impaired. The ratio of tumor resection in navigation group was much higher than that in no - assisted group ( P < 0. 05 ). The ratio of dysfunction in navigation group was much lower than that in no - assisted group ( P < 0. 05). Conclusions Assisted with neuronavigation and electrophysiological monitoring, the tumor and functional area could be located accurately. With excellent skills, good surgical results could be achieved in most brain tumors in functional areas.
