CAJ | 학술논문

目的通过对运动区胶质瘤患者实施术中唤醒配合中央沟定位胶质瘤切除术,初步探讨该技术对运动功能的保护作用.方法对56例运动区附近胶质瘤患者进行喉罩插管、全麻下无头皮夹快速开颅、术中唤醒,通过皮质诱发电位进行中央沟定位,在保护脑功能的同时最大程度切除肿瘤,最后在唤醒状态或全麻下快速关颅.结果所有患者均顺利完成手术,4例患者出现新发神经功能障碍,52例患者术后神经功能障碍无明显加重或改善.肿瘤全切除29例,次全切除20例,大部分切除7例.无出血、围手术期死亡等严重并发症,术后患者均无痛苦回忆.结论唤醒状态配合神经电生理监测中央沟定位切除运动区胶质瘤,能够在保护患者脑功能的前提下最大程度地切除肿瘤,改善患者预后.
목적 통과대운동구효질류환자실시술중환성배합중앙구정위효질류절제술,초보탐토해기술대운동공능적보호작용.방법 대56례운동구부근효질류환자진행후조삽관、전마하무두피협쾌속개로、술중환성,통과피질유발전위진행중앙구정위,재보호뇌공능적동시최대정도절제종류,최후재환성상태혹전마하쾌속관로.결과 소유환자균순리완성수술,4례환자출현신발신경공능장애,52례환자술후신경공능장애무명현가중혹개선.종류전절제29례,차전절제20례,대부분절제7례.무출혈、위수술기사망등엄중병발증,술후환자균무통고회억.결론 환성상태배합신경전생리감측중앙구정위절제운동구효질류,능구재보호환자뇌공능적전제하최대정도지절제종류,개선환자예후.
Objective To study the protective effects of intraoperative waken-up and central sulcus location on motor function for patients with gliomas locating in motor areas.Methods 56 patients with gliomas in motor areas were intubated with laryngeal mask,rapidly underwent craniotomy without scalp clips,waken-up,localized the central sulcus by somatosensory evoked potential.On the condition of protecting the brain function,the greatest degree of tumor resection was performed and then the close-skull under awake state or general anesthesia was finished.Results All the patients underwent operation successfully.Except for the emergence of new nervous dysfunction in four patients,most patients' neurological functions were not deteriorated or even had improved.Besides,there was no complication and postoperative painful memories for the patients.Conclusions Resection of gliomas in motor areas with intraoperative waken-up and localization of central sulcus could ensure the largest degree of tumor resection on the premise of protection of the brain function.As a result,it could improve the prognosis of the patients.