术中超声辅助神经导航在颅内小病灶手术中的应用  

Surgical treatment of 18 cases of intracranial little lesions by neuronavigation with intraoperative ultrasound

作　　者：程伟[1,2,3] 牛朝诗 丁宛海 计颖 姜晓峰 凌士营 傅先明 

机构地区：[1]安徽医科大学附属省立医院神经外科 [2]脑功能与脑疾病安徽省重点实验室 [3]安徽省脑立体定向神经外科研究所,合肥230001

出　　处：《立体定向和功能性神经外科杂志》2013年第1期1-4,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：安徽省临床医学重点项目(编号:2010A001);安徽省科技攻关项目(编号:11010402165);国家临床重点专科建设项目(2011年)

摘　　要：目的探讨术中超声辅助神经导航在颅内小病灶手术中的临床价值。方法总结分析2010年1月至2012年12月我院经术中超声辅助神经导航手术的颅内小病灶18例患者的临床资料,重点分析术中纠正脑移位的意义、超声图像的价值和手术操作技巧。结果颅内小病变18例患者,12例术中发现单纯神经导航脑移位2～8mm,平均4.3mm。术中应用超声辅助神经导航技术定位病灶准确性100%。18例患者,经术后影像学证实病变全切除17例,大部分切除1例。术后偏瘫1例,术后出血1例并经原切口入路清除。术后无死亡病例。结论超声可以纠正神经导航的脑移位,术中超声显示海绵状血管瘤和钙化病变边界最好。术中超声辅助神经导航技术对于寻找定位深部或功能区小病灶意义重大。Objective To investigate the operation process and clinical value of neuronavi- gation with intraoperative ultrasound for treating intracranial little lesions. Methods We retro- spectively analysis the clinical materials of 18 cases of intracranial little lesions which were resec- ted by neuronavigation with intraoperative ultrasound between Jan 2010 to Dec. 2012, and pay at- tention to the correction of brain shift, the value of ultrasound image and operation skills. Results The accuracy of localization of intracranial little lesions was 100%. the distance of brain shift was between 2 to 8mm,with an average 4. 3mm. Total removal of the lesions was achieved in 17 cases, subtotal resection in 1 cases. Hemiplegia happened in 1 case. Recurrent hematoma of 1 case postoperatively was evacuated through the original incision and no death in all the patients. Conclusion Intraoperative ultrasound can correct the brain shift and display most clearly cavern- ous hemangioma and calcified leision. Intraoperative ultrasound is very important to the localiza- tion of intracranial little lesions in deep or functional area.

关 键 词：术中超声 神经导航 颅内小病变 手术技巧 

分 类 号：R741[医药卫生—神经病学与精神病学]