B超实时监测在颅内低级别AVM切除手术中应用  

Aplication of ultrasound real-time monitoring in low level AVM surgery

作　　者：高恒[1] 邹大中[2] 周新民[1] 徐卫东[1] 叶富华[1] 费小斌[1] 

机构地区：[1]东南大学医学院附属江阴医院神经外科 [2]东南大学医学院附属江阴医院B超室

出　　处：《临床神经外科杂志》2012年第4期199-201,共3页Journal of Clinical Neurosurgery

摘　　要：目的探讨术中B超监测结合彩色血管成像技术在颅内深部低级别动静脉畸形(AVM)中的应用价值。方法对采用术中B超定位、彩色血管显像技术监测下显微手术切除的11例低级别AVM结果进行回顾性分析。结果全部11例患者通过应用术中B超实时监测结合彩色血管成像技术,成功完成了AVM切除手术,术后复查CTA无残留。2例意识障碍患者1例术后出现继发性癫疒间,1例为淡漠,记忆下降;3例偏瘫患者,2例术后对侧肢体肌力完全恢复,1例恢复至Ⅲ级;1例合并失语者术后失语恢复;其余头痛为首发症状者症状消失。全部病例无手术相关神经系统功能障碍。本组无死亡。结论采用术中B超实时监测和彩色血管显像技术结合能准确定位,减少手术创伤,同时术中能对AVM供血动脉和引流静脉进行辨别,并对切除程度进行准确评估。Objective To explore the value of combined intraoperative ultrasound real-time monitoring and colorful vascular imaging technology in low level arterionevous malformation （AVM） resection operation. Methods 11 cases of low level AVM were totally resected under intraoperatie ultrasound monitoring combined with color vascular imaging technology. The microsurgical technique and results were analyzed retrospectively. Results All patients obtained complete resection with microinvasive technique. Postoperative CTA comfirmed the result of operation. All patients recovered with different grades. Of 2 coma patients, 1 got secondary epilepsy, the other with apathetic and memory decline. Of 3 hemiplegia patients ,2 recovered satisfactorily, 1 remain grade 3 myodynamia of the controlateral side. The symptom of headache in the other cases were disappeared after operation. No new operation-related symptom occured in this group. Conclusions Intraoperative ultrasound real-time monitoring combined with color vascular imaging techniques could help neurosurgeon in accurate positioning AVM site ,and reducing operative injury in operation, especially in unit without neuronavigation system. This technique can also accurately evaluate feeding vessel and resection degree.

关 键 词：颅内动静脉畸形 超声检查 外科学 

分 类 号：R743.4[医药卫生—神经病学与精神病学]