神经导航在经小切口切除颅内表浅肿瘤术中的应用

Application of neuronavigation in the resection of superficial intracranial tumors with small incision

目的评价神经导航系统在经小切口切除颅内表浅肿瘤中的应用。方法术前对37例病人(导航组)行MRI或CT连续薄层扫描,将影像学资料输入VectorVision2神经导航系统进行三维重建,标记肿瘤后,设计最佳手术入路和头皮切口。术中在导航引导下准确定位并切除肿瘤。以同期30例常规骨瓣开颅手术的大脑半球肿瘤病人(对照组)作为对照。结果导航组均准确全切肿瘤;注册误差0.5～1.6mm,平均(1.12±0.38)mm。导航组平均手术切口长4.9cm,骨瓣面积8.26cm2,出血64.5ml;对照组平均手术切口长13.7cm,骨瓣面积16.34cm2,出血214.1ml。结论与常规手术比较,神经导航引导下经小切口切除颅内表浅肿瘤具有定位准确,创伤小,手术时间短,失血量小及并发症少等优点,值得推广应用。

Objeetive To evaluate the application of neuronavigation in the resection of small superficial intracranial tumors small incision. Methods Thirty-seven patients with superficial intracranial tumors received the continuous thin-slice MR imaging or CT scans before operation, and the data were transported to the neuronavigation system Vector Vision2 for three-dimensional reconstruction. After the tumors were markod, the best surgical approach and scalp incision were designed according to the above data. Under monitoring of neuronavigation, the tumor was resected with precise location. Thirty patients with tumor in the cerebral hemisphere and underwent conventional craniotomy at the same time were chosen as the control group. Results The tumors of the neuronavigation group were resected completely and accurately. The registration deviation in the 37 cases was 0.5-1.6mm （mean 1.12±0.38mm）. For the neuronavigation group and control group, the average incision length was 4.86cm and 13.65cm, the flap size averaged 8.26cm^2 and 16.34cm^2, and the bleeding volume 64.5ml and 214.1 ml respectively. Conclusion Compared with conventional surgery, application of neuronavigation in the surgery of superficial intracranial tumors can get more accurate location, smaller incision, less bleeding and fewer complications, and worth popularizing.