神经导航系统在经蝶窦鞍区肿瘤切除术中的应用

Application of neuronavigation system for the transsphenoidal resection of sellar area tumor

目的 评价神经导航系统在经蝶入路鞍区肿瘤切除手术中的应用。方法 对 13例鞍区肿瘤患者于术前行螺旋 CT增强扫描 ,在导航系统工作站中进行图像三维重建 ,制定手术计划 ,标记重要结构。术中应用导航显微镜系统的镜中导航或导航棒定位 ,指导手术操作。结果 术中导航系统定位准确 ,误差 (1.93± 0 .73) m m。肿瘤全切除 1例 ,次全切除 2例 ,大部切除 1例 ,后 3例患者手术后行放疗。 9例术后症状不同程度好转 ,3例无变化 ,加重 1例。术后发生一过性尿崩 4例 ,脑脊液漏 1例 ,无昏迷、颅内动脉损伤、视神经损伤等严重并发症 ,无手术死亡。结论 神经导航系统辅助经蝶窦鞍区肿瘤切除手术定位准确 ,安全性高 ,有利于提高肿瘤切除率 。

Objective To evaluate the effect of neuronavigation system guided transsphenoidal resection of sellar area tumor Methods 13 patients accepted enhanced helix CT scan before surgery and the images reconstruction,operation plan design and important structures mark were finished in the workstation of navigation system All the operation procedures were done under the guide of navigation system Results The tumor were accurately located with neuronavigation system, and mean error was (1 93±0 73)mm 10 cases were resected totally,2 cases were resected subtotally and cases were resected partially Symptoms were relieved in 9 cases, unchanged in 2 cases and aggravated in 1 case Postoperatively transient diabetes insipidus were found in 4 patients and 1 cerebrospinal fluid leakage occured There was no coma, death and injury of internal carotid artery and optic nerve Conclusion Neuronavigation system is quite useful for accurate location, the tumor removal and reducing the surgical complications