神经导航和皮层“体感”诱发电位监测下中央区胶质瘤的手术治疗

Resection of glioma located in centra area under neuronavigation and cortex sensory evoked potential monitoring

目的：探讨如何在中央区胶质瘤的手术中保护神经功能。方法分析我科2010年1月至2012年10月手术治疗的38例中央区胶质瘤。38例患者均在手术中使用皮层诱发电位监测定位中央前后回，其中25例以神经导航定位肿瘤。结果肿瘤全切32例，6例大部切除。术后功能良好18例，5例较术前未见加重，15例偏瘫加重，其中2例完全瘫痪，但这15例手术后2～6周功能均有不同程度恢复，术后半年随访无完全瘫痪。结论在神经导航和皮层诱发电位监测下，可以在手术中准确定位中央区皮层和肿瘤的位置，使得手术避免直接损伤功能区皮层，有效地保护了患者的神经功能。

Objective To explore how to protect the neuro function of the patient of glioma in central area during operation .Methods 38 patients of glioma in centra area were operated in our department .All patients were underwent evoked potential monitoring during surgery to locate central area.We used neuronavigation to locate the tumor .Results Of 38 patients,32 were totally removed ,6 subtotally removed .After operation, 18 patients had no neurological defect ,5 had no deterioration , while 15 aggravated .These 15 patients improved progressively after discharge and had no fully paralysis half a year later .Conclusion We can protect the central area during operation by using evoked potential monitor to locate the central area and using neuronavigation to locate the tumor .