术中超声在颅脑深部病变显微手术中的临床应用

Clinical application of intraoperative ultrasound in the microsurgeries of the deep brain lesions

目的探讨术中超声(IOUS)在颅脑深部病变显微手术中的临床应用。方法选择2014-08-2016-12在娄底市中心医院住院行IOUS辅助下显微手术治疗颅内深部病变病例41例,并监测全手术过程及手术效果。结果显微手术IOUS硬膜外成像对颅脑深部病变发现率为100%;28例常规手术病例中,IOUS引导病变全切及近全切23例,大部切除5例;13例急诊手术病例中,IOUS辅助下3例脑室内颅内压监测探头置管一次成功,发现5例新发血肿或血肿残腔,均根据病情予以恰当处理;术后CT/MRI复查显示1例肿瘤残留病变IOUS未识别,1例新发小血肿未发现。结论IOUS是一种适用于基层医院的经济实用、简单安全的显微手术辅助技术,不仅提高了颅脑深部病变手术治疗的精准率,而且缩短手术时间,减少出血量,降低术后并发症。

Objective To explore the clinical values of intraoperative ultrasound(IOUS)in the microsurgeries of deep brain lesions in primary hospitals.Methods From August 2014 to December 2016,41 cases of the deep intracranial lesions were chosen to be treated with IOUS assisted microsurgeries in our hospital,and the whole surgical processes and effects were monitored.Results Among the microsurgeries,the detection rate of deep craniocerebral lesions by epidural IOUS was 100%.Postoperative CT/MRI reexaminations showed the IOUS did not identify the residual tumor lesions in a patient,and not detect the new small hematoma in a patient.Among the 28 conventional surgeries,23 cases were total or nearly total resected by IOUS,and 5 cases were subtotal resection.Among the 13 emergency surgeries,IOUS assisted to perform the intraventricular puncture successfully in 3 cases,and find new hematomas or hematoma residuals which were treated appropriately in 5 cases.Conclusion The IOUS is an economical,practical,simple and safe microsurgical assistant technology in the primary hospitals.Not only promotes the accurate treated rate of deep brain lesions,but also it shorten the operation time,reduces the amount of bleeding,reduces postoperative complications.