神经导航显微外科技术在脑动静脉畸形手术中的应用

Role of neuronavigation in microsurgery of introcranial ateriovenous malformation

目的探讨应用神经导航对脑动静脉畸形病灶目标结构定位指引及显微手术切除的效果。方法应用Stryker Leibinger神经导航系统指引显微手术切除43例脑动、静脉畸形，总结分析神经导航在脑动、静脉畸形切除术中的应用技术与效果。结果43例脑动静脉畸形，在满足神经导航注册准确性和术中导航持续准确性的前提下，全部病例均行病灶全切除。出院时所有患者症状均明显改善41例（95．4％），出现新的神经功能缺失2例（4．6％）；全组无死亡病例。结论使用神经导航系统，在术前可制定详细的手术计划，术中可辅助术者按序追踪处理病变血管、准确定位，有助于提高手术安全性及病灶的全切除，降低手术并发症。

Objective To discuss the role of neuronavigaition technique in localizing and facilliating microsurgical resection of intracranial ateriovenous malformations （ AVM ）. Methods Forty-three cases with intracranial AVM treated microneurosurgically asisting by Stryker Leibinger neuronavigation system were retrospectively analyzed. Results After reaching neuronavigation calculated technical accuracy （less than 2 mm） and continual intraoperative navigating accuracy, all of the 43 AVM lesions were completely resected. In 41 patients, syptoms were significantly improved （95.4%） at discharge, new neurofuntion defection were found in 2 patients（4. 6% ）, no death occured. Conclusion Ncuronavigation techniques helps the surgery in planning a precise surgical approach to the targeted AVM lesion and tracing the neurovascular structures,improves the safety of the surgery and the functional outcome of the patients, contribute to lesion resection and reduce operative complications.