大脑半球胶质瘤手术切除技巧与重要脑功能的保护  

Surgical techniques and preservation of brain function during removal of cerebral hemispheric gliomas

作　　者：孙彦辉[1] 刘淑玲[1] 王忠诚[1] 

机构地区：[1]首都医科大学北京市神经外科研究所,北京10005

出　　处：《国际神经病学神经外科学杂志》2008年第4期298-301,共4页Journal of International Neurology and Neurosurgery

摘　　要：目的总结分析大脑半球胶质瘤手术切除的技巧和重要脑功能的保护。方法参照目前国际上对脑胶质瘤的外科手术理念,对连续120例大脑半球胶质瘤患者进行显微外科手术治疗,并根据肿瘤的部位分别采用了唤醒麻醉、术中皮层电刺激、皮层运动诱发电位和体感诱发电位及B型超声实时监测等技术。结果肿瘤全切116例,全切率为96.67%,次全切除4例,占3.33%。出院时KPS评分大于80分的117例,低于80分的3例,无手术死亡,没有去骨瓣病例,也没有因术后颅内血肿或脑水肿而行二次手术的病例。结论应用现代影像学技术进行术前评估、术中使用不同监测技术以及应用恰当的手术技巧能够显著提高大脑半球胶质瘤的手术切除程度和患者的生活质量。Objective To analyze surgical techniques and preservation of brain function during removal of cerebral hemispheric gliomas. Methods 120 consecutive cases with hemisheric gliomas were treated by the microsurgery, and wake-up anesthesia, conical electrical stimulation, motor and somatosensory evoked potential, two-dimensional ultrasound real-time monitoring were utilized during the operations according to the sites of the tumors. Results The tumors were totally removed in 116 patients, sub-totally in 4 cases. The Kanofsky Performance Scores（KPS） of 117 patients were over 80, and of 3 were low 80 when discharged, no death case. Conclusions The extent of resection and quality of life of the patients with cerebral hemispheric gliomas were obviously increased by utilizing modern imaging, intraoperative monitoring techniques and correct surgical techniques.

关 键 词：胶质瘤 大脑半球 手术技巧 脑功能保护 

分 类 号：R739.4[医药卫生—肿瘤]