可移动高场强术中MRI导航辅助切除咽旁间隙恶性肿瘤与传统手术的临床疗效对比  

Comparative study of clinical efficacy between surgery by intraoperative MRI navigation versus traditional surgical resection for malignancy of parapharyngeal space

作　　者：崔江涛[1] 张海钟[2] 布静秋[2] 陈鹏[2] 席庆[2] 步荣发[2] 

机构地区：[1]天津医科大学第二医院,300211 [2]解放军总医院口腔颌面外科

出　　处：《中华医学杂志》2012年第20期1416-1418,共3页National Medical Journal of China

摘　　要：目的对比评价可移动高场强术中MRI导航辅助咽旁间隙恶性肿瘤手术和常规手术的临床疗效。方法对解放军总医院口腔颌面外科2010年2月—2011年2月的29例被确认为咽旁间隙恶性肿瘤患者应用1．5T术中MRI导航辅助手术，并回顾性分析42例常规手术行恶性肿瘤切除，比较手术疗效指标。结果两组患者的年龄、性别、肿瘤最大直径、肿瘤分期、手术人路、病理诊断差异无统计学意义（P〉0．05），而两组的疗效指标：手术时间导航组多于常规组[（3．1±0．6）h比（2．7±0．7）h]，差异有统计学意义（P〈0．05）；而术中出血[导航组比常规组，下同：（185±20）ml比（230±22）ml]、术后72h内引流量、首次手术切缘阳性率、术后住院时间[（9．1±2．1）d比（10．3±2．3）d]和并发症发生率（3．4％比9．5％），导航组均少于常规组，差异均有统计学意义（均P〈0．05）。结论可移动高场强术中MRI导航辅助手术与传统手术相比，具有较好的手术临床疗效。Objective To investigate the clinical efficacy between mobile intraoperative magnetic resonance imaging （iMRI） navigation with a high field strength and routine surgical resection for malignancy of parapharyngeal space. Methods The surgical efficacy indexes of patients at our hospital during the time range from February 2010 to February 2011 were compared between two groups consisting of 29 or 42 individuals undergoing surgery with the assistance of the technique of iMRI navigation with a high field strength 1.5T or routine operation. Results No difference existed between two groups in terms of age, gender, maximal diameter of tumors, tumor stages, surgical approach or pathologic diagnosis （ P 〉 0. 05 ）. The operative duration of the group by iMRI navigation was more than the group of routine operation（ （3.1±0. 6） h vs （2. 7 ±0. 7 ） h, P 〈 0. 05 ）. And the hemorrhagic loss （ （ 185 ±20 ） ml vs （ 230 ± 22 ） ml）, the volume of drainage in 72 hours, the positive rate of initial surgical margins, the postoperative hospital stay （ （9. 1± 2. 1 ） d vs （ 10. 3 ± 2. 3 ） d） and the complication incidence rate （ 3.4 % vs 9. 5 % ） were less （ all P 〈 0. 05）. Conclusion The operation by the iMRI navigation offers a much better clinical efficacy than the traditional surgery in the resection of malignancy of paraphary^geal space.

关 键 词：磁共振成像 外科手术 计算机辅助 肿瘤 咽旁间隙 

分 类 号：R739.6[医药卫生—肿瘤]