CT立体定向脑内病灶直视手术(附83例临床分析)

The direct vision operation of intracerebral lesions by CT-guided stereotaxy (report of 83 cases )

目的 探讨CT导向在脑内病灶定位及全切除手术中的价值。方法 使用Leksell G型定向仪 ,CT扫描定位 ,立体定向下直视手术。结果 本组 83例 ,均达到病灶全切除或CT所标志的肿瘤边界内全切除 ,无手术死亡。术后偏瘫加重 8例 ,面瘫 4例 ,不完全运动性失语 5例 ,均于 1～ 2周内消失或恢复至术前状态 ,无神经功能进一步损害。病理 :星形细胞瘤 2 8例 ,少枝胶质瘤 8例 ,室管膜瘤 5例 ,脑膜瘤 4例 ,海绵状血管瘤 6例 ,小型脑动静脉畸形 3例 ,脑转移瘤 9例 ,脑脓肿 5例 ,脑囊虫 9例 ,结核瘤 2例 ,裂头蚴 3例、黑色素瘤 1例。结论 CT导向脑内小病灶切除或等体积切除 ,定位准确 。

Objective To evaluate the value of CT guided stereotaxy in the precise localization for the complete removal of brain lesions. Methods Leksell G head frame was affixed to the patient's head and underwent CT scanning, the cranial trephination was performed. Results In this series of 83 patients, all lesions were either completely removed, or total resection of the tumors under the CT orientation, there was no mortality. 8 patients had deterioration of hemiplegia after surgery, 4 patients developed pronounced aphasia, but all of these patients recovered during 1～2 weeks after operation. No more neurological deficits appeared in other patients . The clinicopathological examination showed: 28 cases with astrocytoma, 8 cases with oligodendroglioma, 5 cases with ependymoma, 4 cases with meningioma, 6 cases with cavernous angioma, 3 cases with small AVMs, 9 cases with metastatic tumor of brain, 5 cases with intracerebral abscess, 9 cases with brain cysticercosis, 2 cases with tuberculoma of brain, 3 cases with sparganosis mansoni, 1 case with melanoma. Conclusion CT guided operations in small lesion removal or volumetric stereotactic resection, are much accurate and minimally invasive.