术中超声在颅脑深部病灶显微切除术中的应用  

Intraoperative ultrasound-guided microsurgery for intracranial deep lesions

作　　者：黄锦峰[1] 喻军华[1] 王璨[1] 陈志勇[1] 袁学刚[1] 刘斌[1] 吴新宇[1] 胡太可 

机构地区：[1]鄂州市中心医院神经外科,436000

出　　处：《中国微侵袭神经外科杂志》2014年第11期497-499,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的：探讨术中超声在定位颅脑深部病灶、引导切除、实时监测方面的应用价值。方法回顾性分析16例显微手术切除的颅脑深部病灶病人的临床资料,术中行超声定位,确定病灶部位、大小、范围及其与周围结构的关系,选择最佳手术路径并引导手术切除过程,监测病灶切除范围及程度,对手术效果进行评估。结果病灶全切除14例,次全切除2例。除1例侵袭性肿瘤外,术中超声检测切除程度结果与术后 CT 和（或） MRI 结果一致。术后1例出现神经功能障碍加重,1例并发颅内感染,对症处理后好转。无死亡病例。随访1~12个月,病人一般情况良好。结论术中超声能准确定位颅脑深部病灶,并指导病灶的完整切除,保护周围重要神经功能结构,减少手术副损伤,值得推广。Objective To explore the application value of intraoperative ultrasound in microscopic resection of intracranial deep lesions. Methods Clinical data of 16 patients with intracranial deep lesions were analyzed retrospectively, who underwent intraoperative ultrasound-guided microsurgery. Intraoperative ultrasound was used to determine the location, size, range of lesion and its relationship with the surrounding structures in order to choose the best approach and provide the guidance for resection, monitor the scope and extent of resection and evaluate the surgical outcome. Results Complete removal of the lesions was achieved in 14 patients and subtotal removal in 2. Intraoperative ultrasound results of 16 patients showed that the resection extent was in accordance with postoperative CT and / or MRI except 1 with invasive tumor. After microsurgery, the neurological impairment was aggravated in 1 patient and intracranial infection occurred in 1, both of whom recovered after symptomatic treatment. No death happened. All the patients were followed up for 1 to 12 months, and recovered well. Conclusions Intraoperative ultrasound can accurately locate the intracranial lesions, and is helpful to guide total resection and protect the important surrounding structures and reduce the surgical complications, thus being worthy to be popularized clinically.

关 键 词：超声检查 术中 颅内病变 深部 监测 动态 

分 类 号：R651.1[医药卫生—外科学] R445.1[医药卫生—临床医学]