CAJ | 학술논문

目的：探讨手术中超声（ IOUS）在切除颅内皮层下病变的应用价值。方法对35例患者中的39处颅内皮层下病变在开颅手术中使用IOUS进行精确定位，寻找最佳手术入路，并引导手术切除的全过程，明确病变切除范围并且观察残余情况。结果在超声引导下精确定位并且完整切除病变28例，次全切除5例，大部分切除2例。28例非功能区病变（全切除）患者术后均无局灶性神经功能障碍，7例功能区病变患者中4例术后瘫痪加重，半年后恢复至术前水平。结论 IOUS可准确定位颅内皮层下病变，指导最佳手术入路，引导术中病变的完整切除，保护周围正常神经功能结构，提高了全切率和手术疗效，降低了复发率和并发症，实时性、安全性和实用性使其具有临床应用前景和价值。
목적：탐토수술중초성（ IOUS）재절제로내피층하병변적응용개치。방법대35례환자중적39처로내피층하병변재개로수술중사용IOUS진행정학정위，심조최가수술입로，병인도수술절제적전과정，명학병변절제범위병차관찰잔여정황。결과재초성인도하정학정위병차완정절제병변28례，차전절제5례，대부분절제2례。28례비공능구병변（전절제）환자술후균무국조성신경공능장애，7례공능구병변환자중4례술후탄탄가중，반년후회복지술전수평。결론 IOUS가준학정위로내피층하병변，지도최가수술입로，인도술중병변적완정절제，보호주위정상신경공능결구，제고료전절솔화수술료효，강저료복발솔화병발증，실시성、안전성화실용성사기구유림상응용전경화개치。
Objective To investigate the value of intra-operative ultrasound ( IOUS ) in resection of subcortical occupying lesions .Methods 39 intracranial space-occupying lesions in 35 patients were located accurately to find the optimal operative approach via using IOUS , and guided for resection in the whole process of operation .Simultaneously , resection range and residuals of lesions were observed clearly .Results All lesions were located exactly and resected totally .28 focuses in non functional area and seven focuses in functional area were resected totally and no significant focal neurological dysfunction was observed postoperatively .Acroparalysis in four patients became more serious compared to preoperative situation .But myodynamia restored to preoperative level six months later via rehabilitation training .Conclusions Subcortical occupying lesions were located exactly and guided the optimal operative approach to resect the lesions via IOUS .Not only IOUS protected normal neuro and vascular structures from damaging and improving the total removal rate and the effect of operation , but also reduced the recurrence rate and complications .The instantaneity , safety and practicability of IOUS exerted the clinical application prospect and value .