神经导航技术结合术中B超检查在功能区胶质瘤手术中的应用

Surgical treatment of functional glioma by neuronavigation with intraoperative ultrasound

目的：探讨神经导航技术结合术中 B 超检查对功能区胶质瘤的手术入路、切除范围及功能保护及术后复发的影响；术中 B 纠正脑移位的意义。方法回顾性分析24例功能区胶质瘤患者的临床资料，术中使用神经导航对功能区胶质瘤进行空间三维定位，并使用术中 B 超进行辅助操作及了解肿瘤与周围血管位置关系。结果24例患者患者中，神经导航脑移位2～10 mm，平均4．7 mm，术中使用 B 超结合神经导航技术全部精确定位病灶；术后24 h 核磁共振检查证实，21例全切除，3例次全切除；术后患者功能改善者20例，未改善者2例，术后偏瘫2例，无死亡病例。结论神经导航技术结合术中 B 超检查可纠正脑移位，提高功能区胶质瘤的精确定位，提高肿瘤全切率，减少术后功能障碍，提高患者生存期及生存质量。

Objective To investigate the operation process,extent of resection,protection function,the tumor recurrence and clicical value of neuronavigation with intraoperative ultrasound for treating functional glioma;signifi-cance of intraoperative ultrasound for correcting brain shift.Methods We analyzed the cliclical materical of 24 case of functional gliomas which were resected by neuronavigation with intraoperative ultrasound.Results The accuracy of localization of functional glioma was 100%.The distance of brain shift was 2 to 10mm,with an average 4.7mm.After 24 hours MRI confirmed that total removal of function glioma was achieved in 21 cases,subtotal in 3 cases.After oper-ation function improve was 20 cases,invalid of 2 cases,hemiplegia happened in 2 cases and no death in all the patients.Conclusion Neuronavigation with intraoperative ultrasound can correct brain shift and improve the accuracy of localization of functional glioma,to improve extent of function glioma and decrease dysfunction.Neuronavigation with intraoperative ultrasound is important to functional glioma.