神经导航在脑内小病灶手术中的应用(附25例报道)

Application of neuronavigation in resetion of intracranial small lesions(analysis of 25 cases)

目的探讨神经导航辅助显微手术治疗脑内小病灶的应用价值。方法用神经导航系统辅助显微外科手术切除25例脑内小病灶。术前将头颅CT或MRI连续薄层扫描所获取的影像资料输入神经导航系统进行三维重建并注册,制定手术计划。术中实时导航指导手术切除范围,分析治疗结果。结果导航平均注册误差2.12±0.73mm,术中准确定位病灶。病灶全切23例,次全切2例。术后22例病人症状改善或无变化,3例原有神经症状加重或出现新的神经功能损害。结论神经导航能准确引导切除脑内小病灶,减少手术创伤,提高手术效果,降低死亡率、病残率,在显微神经外科手术中具有重要的临床应用价值。

Objective To evaluate the utility of neuronavigator--assisted microsurgery to the treatment of intraeranial small lesions. Methods The intracranial small lesions were resected by neuronavigator assisted microsurgery in the 25 patients. Before the surgery, the data of a continuous CT or MRI scanning were inputted into the neuronavigation system for 3D reconstruction and registration, and then designing the operative approach. During the surgery, the lesion can be located accurately. Removal range were decided. The clinicaldata and postoperative outcome were analized. Results The mean registration error was 2. 12±0. 73 mm in all patients with intracranial small lesions . The lesions and its surrounding structure were located accurately during the operation. In the 25 patients,23 received total resection of the lesions, 2 subtotal, in 22 patients, Neurological symptoms improved or unchanged, in 3 patients , postoperative neurological symptoms becamed severe or new deficience of neuronal function appeared. No complications and death of operation attributed to the use of neuronavigation system. Conclusion The neuronavigation system can accurately locates the intraeranial small lesions, reduces the surgical lesions,improves the surgery efficacy, and depresses the mortality and disabled rate. It has important clinical value in the microneurosurgery .