脑胶质瘤清醒麻醉开颅和全麻开颅术后疗效比较

Efficacy comparison between awake anesthesia craniotomy and general anesthesia craniotomy for gliomas

目的比较清醒麻醉开颅和全麻开颅对脑功能区胶质瘤术后的疗效。方法回顾性分析80例脑胶质瘤病例资料,其中清醒麻醉(awake anesthesia,AA)开颅40例(AA组),全身麻醉(general anesthesia,GA)开颅40例(GA组)。结果两组在术中失血量、手术时间、术后癫痫发生率、术后1周语言和肢体功能改善率无明显差异。术后AA组肿瘤全切程度比GA组高,住院时间比GA组短,恶心呕吐发生率比GA组低,术后2个月的KPS比GA组高。结论AA下行开颅脑功能区胶质瘤切除术安全可行,可提高肿瘤全切程度,为临床肿瘤切除提供指导。

Objective To compare the postoperative outcomes of awake anesthesia(AA)craniotomy and general anesthesia(GA)craniotomy for gliomas in eloquent areas.Methods The clinical data of 80 patients with glioma were analyzed retrospectively,including 40 cases of craniotomy under awake anesthesia(AA group)and 40 cases of craniotomy under general anesthesia(GA group).Results There was no significant difference between the two groups in the intraoperative blood loss,operation time,incidence of postoperative epilepsy,improvement rate of language and limb function one week after the operation.The rate of total tumor resection was higher,the hospital stay was shorter,the incidence of nausea and vomiting was lower,and the KPS at 2 months after surgery was higher in the AA group than that in the GA group.Conclusions Resection of glioma in eloquent areas under awake anesthesia is safe and feasible,can improve the rate of total tumor resection and provide guidance for clinical tumor resection.