神经导航联合荧光素钠术中显影辅助切除脑转移瘤的应用分析

Application of neuronavigation combined with fluorescein sodium in intraoperative imaging⁃assisted resection of brain metastases

目的探讨神经导航联合荧光素钠(fluorescein sodium,FLS)术中显影辅助在脑转移瘤手术中的疗效。方法回顾性分析2019年1月—2022年10月广西医科大学附属肿瘤医院神经外科治疗的125例脑转移瘤(brain metastasis,BM)手术患者的临床资料。将神经导航联合FLS术中荧光显影辅助手术切除的87例BM患者归为神经导航联合荧光素钠组,单纯神经导航下手术切除的38例BM患者归为神经导航组纳入研究,比较两组肿瘤切除程度、手术时间、出血量、并发症及术后1个月卡氏功能状态(karnofsky scale,KPS)评分。结果神经导航联合荧光素钠组全切率为85.1%,明显高于神经导航组的65.8%(P=0.028)。校正可能的混杂因素后,神经导航联合荧光素钠组的全切率是神经导航组的1.849倍(OR=1.849,95%CI:1.130~3.026,P=0.014)。神经导航联合荧光素钠组的术后1个月KPS评分高于神经导航组(78.96±13.81 vs 65.00±18.56,P<0.001),两组间差异有统计学意义(P<0.001)。神经导航联合荧光素钠组的手术时间、出血量均少于神经导航组(均P<0.05),但两组并发症发生率比较差异无统计学意义(P>0.05)。结论神经导航联合FLS术中荧光辅助切除BM能提高肿瘤全切率,改善患者短期生活质量,且具有较好安全性。

Objective To investigate the ffccy of neuronavigation combined with fuorescein sodium(FLS)in intraoperative imagingasited resection of brain metastases.Methods The clincal data of 125 sungical patients with brain metastasis(BM)treated in neurosurgery department of Guangxi Medical Univensity Cancer Hospital from January 2019 to October 2022 were retrospectively analyzed.Among these BM patients,87 patients who underwent neuronavigation combined with FLS intraoperative imaging-assisted resection were classfied into the neuronavigation combined with FLS group,and 38 patients who underwent surgical resection under newonavigation alone were cdassified into the neuronavigation group.The degree of tumor resection,surgical time,blood bleeding,complications,and 1-month postoperative karnofsky scale(KPS)scores were compared between the two groups.Results The total resection rate of the neuronaviga-tion combined with FLS group was 85.1%,which was signifcantly higher than that(65.8%)of the neuronarigation group(P=0.028)-After adjusting for possible confounding factors,the total resection rate of the newronavigation combined with FLS group was 1.849 times higher than that of the neuronavigation group(OR=1.849,95%CI:1.130-3.026,P=0.014).The KPS scores of the neuronavigation combined with FLS group was signifcantly higher than that of the newronavigation group at 1 month after surgery(78.96+13.81vs65.00±18.56,P<0.001).The diference between the two groups was staistically signifcant(P<0.001).The surgical time and blood bleeding of the neuronavigation combined with FLS group were lower than those of the neuronavigation group(all P<0.05),though no significant difference in complications was found between the two groups(P>0.05).Conclusions Neuronavigation combined with FLS assisted BM resection surgery can improve the total tumor resection rate and the short⁃term life quality of patients with safety.