电磁导航辅助显微手术切除颅内海绵状血管瘤  

Microsurgical resection of intracranial cavernous hemangioma with the guide of electromagnetic navigation

作　　者：宋启民[1] 程彦昊[1] 戴超[1] 费昶[1] 王新功[1] 张健[1] 姬传林[1] 

机构地区：[1]山东省临沂市人民医院神经外科,山东省临沂市276000

出　　处：《中华显微外科杂志》2013年第6期524-527,共4页Chinese Journal of Microsurgery

基　　金：山东省卫生厅医药卫生发展计划青年基金（2011QW008）

摘　　要：目的探讨电磁导航系统在辅助显微手术切除颅内不同位置海绵状血管瘤中的价值。方法采用电磁导航系统辅助显微手术切除颅内不同位置海绵状血管瘤，43例患者47个海绵状血管瘤，3例为多发海绵状血管瘤，其中1例3个，另2例2个；包括大脑皮层深部25个（包括小脑深部4个），大脑皮层浅部20个，眶尖2个。本组47个血管瘤中中央区深部4个，语言中枢深部4个，枕叶视觉中枢深部2个。结果本组43例患者47个海绵状血管瘤，定位准确性100％，手术全切率为100％，其中18个用小直切口切除病灶。术后神经功能障碍无加重病例，无死亡病例，术后发生正常灌注压突破出血1例，经保守治疗后治愈；30例术后1周内出院，34例术中出量少于50ml。术中导航注册的精确度为（1．6±0．4）mm。结论电磁导航系统术前可以帮助设计手术切口及手术入路；术中可以实时指导术者操作，准确切除病变同时避开脑功能区，保护正常脑组织，减少术后并发症。电磁导航系统特别适合颅内海绵状血管瘤的微创手术切除。Objective To investigate the value of electromagnetic navigation in microsurgical resection of intracranial cavernous hemangioma of different locations. Methods The microsurgical resection of intracranial cavernous hemangioma of different locations with the guide of electromagnetic navigation of COMPASS Cygnus system, There were 47 cavernous hemangioma of 43 patients, including of multiple cavernous hemangioma of 3 cases, one case had 3, the other 2 cases had 2 ; Including 25 deep in the cerebral cortex（ including of 4 deep in the cerebellar cortex） , twenty shallow in the cerebral cortex,two were in the orbital apex, including of 4 deep in the sensorimotor cortex, four deep in the language center, and 2 deep in the visual center. Results All 47 cavernous hemangioma of 43 patients, the accuracy was 100%. The resection rate was 100%, including of 16 patients were removed with a straight incision. There was no one with the neurological dysfunction worse postoperative, with no deaths, with 1 case of normal peffusion pressure breakthrough and was cured by conservative treatment. Thirty cases were discharged within 1 week. The blood loss of 30 cases was less than 50 ml. The average registration error of navigation was 1.6 ± 0. 4 mm. Conclusion The surgical incision and surgical approach can been designed with the help of electromagnetic navigation system before operation, and can accurately resect the lesions simultaneously avoid brain function area, protect the normal brain tissue, reduce postoperative complications, with the help of the electromagnetic navigation system intraoperative in real time. It is suitable for minimally invasive surgery for intracranial cavernous hemangioma.

关 键 词：海绵状血管瘤 电磁导航 显微神经外科手术 

分 类 号：R651.1[医药卫生—外科学]