功能导航在额顶叶胶质瘤手术中的应用

The application investigation of functional neuronavigation in glioma resection in frontal and parietal lobes

目的:探讨应用功能导航与术中唤醒麻醉联合皮层刺激在手术切除额顶叶胶质瘤中保护运动功能的临床价值。方法:将157例额顶叶胶质瘤患者,分为导航组(91例)和唤醒组(66例):导航组术中采用BOLD-fMRI联合DTI-FT神经导航技术;唤醒组术中采用唤醒麻醉联合脑皮层电刺激技术。分析患者运动功能保护效果、肿瘤切除率及手术时间。结果:导航组与唤醒组在运动功能保护上效果相当(P>0.05)。导航组肿瘤切除率优于唤醒组(P<0.05)。导航组手术时间比唤醒组短(P<0.05)。结论:BOLD-fMRI联合DTI-FT神经导航技术在切除额顶叶胶质瘤术中运动功能保护与作为金标准的唤醒麻醉效果相当,且能提高肿瘤切除率,减少手术时间,进而改善患者的生存质量,值得推广。

Objective：To explore the clinical value of motor function protection of functional neuronavigation and intraoperative waking-up anesthesia combined with cortical stimulation in glioma resection in frontal and parietal lobes.Methods：157 patients received frontal or parietal glioma resection were separated into two groups randomly.Navigation group of 91 patients using BOLD-fMRI combined with DTI-FT neuronavigation to remove tumor,waking-up group of 66 patients using intraoperative anesthesia combined with cortical electrical stimulation to remove tumor.Results：Results of motor function protection are no difference between navigation group and waking-up group（P〉0.05）.Results of tumor resection ratio are differences between navigation group and waking-up group（P〈0.05）.Results of operation duration are differences between waking-up group and navigation group（P〈0.05）.Conclusion：Both of BOLD-fMRI combined with DTI-FT neuronavigation and intraoperative waking-up anesthesia combined with cortical electrical stimulation showed motor function protective effect in frontal and parietal glioma resections.There was no difference between them,while BOLD-fMRI combined with DTI-FT neuronavigation has higher tumor resection ratio and shorter operation duration than intraoperative waking-up anesthesia combined with cortical electrical stimulation in frontal and parietal glioma resections.Further,it improves the quality of life of patients,so,it is worth to broader implementation.