术中B超在颅内病变手术中的临床应用

Intraoperative B-ultrasound in Surgery of Intracranial Lesions in the Clinical Application

目的探讨术中B超在颅内病变手术中的应用价值。方法术中对病变进行彩色多普勒检查,在颅脑手术开颅后,手术过程中指导手术入路、皮层进入点、明确与周围结构的关系,指导手术切除病变。对术中急性脑膨出,尤其是颅脑损伤疑有多发性及迟发性颅内血肿者实行术中B超检查,迅速判断出血部位,指导及时有效手术治疗。结果 B超辅助下手术32例。胶质瘤8例,脓肿2例,海绵状血管瘤4例,寄生虫病2例,脑膜瘤1例,血肿15例。B超引导下血肿清除术15例,经术中B超辅助下准确切除病变17例。术中颅内病变定位准确,无需探查,病变切除彻底,脑组织损伤轻微,未出现相应明显的神经系统障碍。结论术中B超对于囊性或边界清楚的颅内病变以及功能区病变,具有明显的无创伤定位优势,对指导颅内病变的手术很有价值。术中B超对多发性迟发性颅内血肿能迅速、准确定位,对明确术中急性脑膨出的原因、指导及时有效的手术治疗有重要的意义。

Objective To investigate the application of intraoperative color Doppler ultrasonography to microsurgery for the intracranial lesions. Methods The color Doppler ultrasonography in microsurgery for the intracranial lesions was used to se- lect the right operative approach, locate the right position to find the lesions, size and structure of the intraeranial lesions. Not only, but it also was used in acute encephalocele, especially in Delayed traumatic intracranial hematoma to find the bleeding site and instruct the effective treatment. Results The 32 intracranial lesions were exactly located by intraoperative color Doppler ul- trasonography. It included 8 patients with glioma, 2 patients with brain abscess, 4 patients with cavernous hemangioma, 2 pa- tients with parasitic encephalopathy, 1patients with Meningioma, 15 patients with cerebral hematoma. 14 received total resection of the lesions andl5 received Hematoma aspiration. With intraoperative color Doppler ultrasonography, the position was right, the lesion was absolutely reseeted, and the brain tissue injury was slight, no neurological impairment appeared. Conclusion Color doppler uhrasonography performed the advantage of slight damage in intracranial cystic lesions or distint lesions. And it is also helpful to find the location of delayed traumatic intracranial hematoma, the reason of acute encephalocele. Thereby, it could help us discover exact resection of the lesions and decreasing the postoperative complications and effective surgical treatment.