神经导航联合脑皮质电图监测在切除脑功能区胶质瘤中的应用

Neuronavigation and electrocorticography monitoring in resection of eloquent brain glioma： analysis in 36 cases

目的探讨神经导航联合脑皮质电图监测在脑功能区肿瘤手术中的作用和意义。方法脑功能区脑胶质瘤患者36例，在神经导航联合脑皮质电图监测下进行显微外科手术，观察其手术效果及并发症发生率。结果神经导航注册精度位（2．04-0．5）mm，利用导航设计的皮瓣与骨瓣完全符合手术要求；术中肿瘤全切除31例，次全切除5例，术后神经功能改善，无明显并发症，无死亡。结论术中电生理技术能对导航确定的功能区进行再确认，解决术中脑移位及功能构建问题，有助于提高肿瘤全切除率及减少并发症。

Objective To investigate the effects and significance of neuronavigation and electrocorticography monitoring in resection of eloquent brain glioma. Methods Thirty-six cases with intracranial tumors accepted microneurosurgery resection under neuronavigation and electrocorticography monitoring. The clinical data and postoperative outcome were analyzed. Results The mean registration error was （ 2.0 ± 0. 5 ） mm in all operations and all skin flaps and bone windows designed by neuranavigation could fit the operation demands. Total resectin of the tumor was achieved in 31 cases and subtotal resection in 5 cases. Neurological symptoms improved and no severe complications or death happened in all patients. Condusion Neuronavigation combined with electrocorticography monitoring can accurately locate the eloquent glioma and retrieve the brain shift. This method is a real.time technique and has functional test ability. It can improve the total removal rate and decrease the mortality and disabled rate.