实时超声引导下显微手术切除脑深部病灶

Resecting Deep Brain Lesions by Intraoperative Real-Time Ultrasound-guided Microneurosurgery

目的探讨术中超声引导在脑深部病灶显微手术中的应用价值。方法自2004年开始我们在脑深部病灶显微手术中采用实时超声引导病灶定位,指引手术中皮层入路及路径的选择,并使用术中超声影像动态了解病变位置的变化情况、手术切除的范围,利用实时影像辅助判断病变切除程度。结果28例脑深部病灶,病灶直径为1.0～5.9cm,病理诊断包括蛛网膜囊肿5例,海绵状血管瘤2例,动静脉畸形2例,肿瘤7例,脑内血肿12例。所有病例均显微镜下全切,术后28例患者均恢复良好,神经功能保存良好,无新的神经功能损害,无手术并发症。结论术中超声引导是一种简便有效的脑深部病灶定位方法,操作简便,定位准确,能够实时指引手术路径和动态了解手术切除病灶的范围,与显微神经外科配合能够有效地避免额外的手术损伤,提高手术精度。

Objective To explore the application of intraoperative ultrasound-guided microneurosurgery to resecting deep brain lesions. Methods Twenty-eight patients with deep brain lesions, of whom, 5 suffered arachnoid cysts, 2 cavernomas, 2 arteriovenous mlformations, 7 brain tumors and 12 intracerebral hematomas, were treated by uhrasound-guided microsurgery. Real-time ultrasound-guidance was done anytime during the operation, if necessary. Under the ultrasound-guidance, the lesions were exactly located, the good operative approaches were selected, and the extent of the resected lesions was known. Results All the lesions were totally removed by the uhrasound-guided microneurosurgery in 28 patients. There were no additional neurological function damages or complications in 28 patients, who were recovered well after the operation. Conclusion Intraoperative ultrasound-guided microneurosurgery is of good curative effect on the treatment of deep brain lesions. The intraoperative real-time ultrasound-guidance is helpful to decrease in the injury due to the operation and increase in the operative accuracy.