CAJ | 학술논문

目的：探讨电磁导航和术中 B 超在脑功能区脑动静脉畸形显微治疗中的作用。方法分析2005年5月至2013年5月手术治疗的脑功能区血管畸形41例，其中2008年后使用电磁导航和术中 B 超辅助23例（辅助组），2008年前未使用18例（未辅助组），未辅助组直接行显微手术切除脑动静脉畸形。辅助组采用电磁导航、术中 B超等技术确定脑动静脉畸形边界和脑功能区，根据脑动静脉畸形和功能区的关系切除脑动静脉畸形。结果未辅助组畸形全切11例，次全切7例，术后功能良好10例，无变化2例，功能障碍加重6例，辅助组电磁导航系统定位成功率100％，图像匹配误差0．86～3．10 mm，平均1．52 mm，畸形全切21例，次全切2 例，术后功能良好18例，无变化 3例，功能障碍加重2例，两组畸形全切除率及术后功能障碍发生率差异有统计学意义（P ＜0．05）。结论在电磁导航系统和术中 B 超的辅助下，可以做到精确的病灶解剖和脑功能定位，可提高脑血管畸形切除术手术精度，减少手术并发症。
목적：탐토전자도항화술중 B 초재뇌공능구뇌동정맥기형현미치료중적작용。방법분석2005년5월지2013년5월수술치료적뇌공능구혈관기형41례，기중2008년후사용전자도항화술중 B 초보조23례（보조조），2008년전미사용18례（미보조조），미보조조직접행현미수술절제뇌동정맥기형。보조조채용전자도항、술중 B초등기술학정뇌동정맥기형변계화뇌공능구，근거뇌동정맥기형화공능구적관계절제뇌동정맥기형。결과미보조조기형전절11례，차전절7례，술후공능량호10례，무변화2례，공능장애가중6례，보조조전자도항계통정위성공솔100％，도상필배오차0．86～3．10 mm，평균1．52 mm，기형전절21례，차전절2 례，술후공능량호18례，무변화 3례，공능장애가중2례，량조기형전절제솔급술후공능장애발생솔차이유통계학의의（P ＜0．05）。결론재전자도항계통화술중 B 초적보조하，가이주도정학적병조해부화뇌공능정위，가제고뇌혈관기형절제술수술정도，감소수술병발증。
Objective To explore the efficacy of electro-magnetic navigation and ultrasound in microsurgical treatment of brain arteriovenous malformation (AVM)in cerebral functional areas.Methods Clinical data of 41 cases of AVM treated in our hospital during May 2005 to May 2013 were retrospectively reviewed.The cases could be divided into 2 groups:the assisted group which received operation assisted with electro-magnetic navigation and ultrasound (n =23), and the non-assisted group which were treated solely with microsurgery (n =18).In the assisted group,after AVM and functional areas were located by electro-magnetic navigation and ultrasound,AVM was removed with reference to the relationship between AVM and functional areas.Results In non-assisted group,AVM was totally removed in 11 cases and subtotally removed in 7 cases.After operation,10 cases recovered,2 cases had no change,and 6 cases were im-paired.In the assisted group,all intracranial lesions were accurately located.The matching error was 0.86-3.10 mm, mean 1.52 mm.The AVM was totally removed in 21 cases and subtotally removed in 2 cases.After operation,18 ca-ses recovered,3 cases had no change,and 2 cases were impaired.The ratio of AVM resection in the assisted group was much higher than that in the non-assisted group.The ratio of dysfunction in the assisted group was much lower than that in the non-assisted group (P <0.05 ).Conclusion Assisted with electro-magnetic navigation and ultrasound,the AVM and functional area can be accurately located and complications can be substantially reduced.