术中超声引导下的颅内病变显微手术治疗

Intraoperative sonography-guided microsurgery for intracranial lesions (a report of 18 cases)

目的探讨彩色多普勒超声引导定位技术在颅内病变显微手术中的应用价值。方法术中对病变进行彩色多普勒超声检查,确定病变部位、大小、范围、病变内部及周围血供情况,选择最佳手术路径,在显微镜下切除病变,并对手术效果进行评估。结果 18例病变全部定位准确。其中2例患者行脑积水分流术,16例病变全切14例,次全切除2例。仅有1例术后出现神经功能障碍加重,无严重手术并发症,无围手术期死亡病例。结论术中颅脑彩色多普勒超声可实时显示病变的部位和范围,有助于病变的术中定位和手术路径的选择,能够准确的切除病灶,最大程度减少手术的副损伤,具有重要的临床应用价值。

Objective To explore the value of intraoperative color Doppler uhrasonography to microsurgery for the intracranial lesions. Methods The color Doppler ultrasonography was intraoperatively used to locate the right position and size of the intracranial lesions. The operative approaches were selected and microsurgery was performed under the guidance of the uhrasonography in 18 patients with intracranial lesions. The operative effect on the intracranial lesions was assessed after the surgery. Results The intracranial lesions were exactly located in all the patients. The shunt was successfully performed in 2 patients with hydrocephalus. Of 16 patients with intracranial space-occupying lesions, 14 received total resection of the lesions and 2 subtotal. After the operations, neurological impairment was aggravated in 1 patient. There were no serious complications and no patient died in all the patients. Conclusions Color doppler uhrasonography, by which the lesions may be located and their size may be determined, is helpful to selecting the operative approach, exact resection of the lesions and decreasing the postoperative complications.