多模态神经导航系统在岩骨-斜坡区肿瘤切除术中的临床应用  

Clinical Application of Multimodal Neuronavigation System in Petroclival Tumor Resection

作　　者：赵君爽 李龙[1] 张天鼎 陈炼 周锦鹏[1] 景治涛[1] ZHAO Junshuang;LI Long;ZHANG Tianding;CHEN Lian;ZHOU Jinpeng;JING Zhitao(Department of Neurosurgery,The First Hospital,China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院神经外科

出　　处：《中国医科大学学报》2019年第9期774-777,共4页Journal of China Medical University

基　　金：国家自然科学基金(81101917)

摘　　要：目的探讨多模态神经导航系统在岩骨-斜坡区(简称岩斜区)肿瘤手术中的临床应用,提高岩斜区肿瘤切除手术的安全性。方法选择2013年1月至2019年1月行岩斜区肿瘤切除手术病例87例。其中,35例在多模态神经导航系统辅助下手术切除(多模态组),52例在无术中实时影像学指导下手术切除(对照组)。对患者的病史、影像学检查、肿瘤切除情况、术前术后神经功能状态及术后并发症等进行分析,定期随访,记录患者的神经功能状态、生活质量等。结果多模态组肿瘤完全切除率(30/35,85.7%)明显高于对照组(33/52,63.5%),差异有统计学意义(P<0.05)。对照组术后并发症发生率(17/52,32.7%)高于多模态组(8/35,22.9%),但差异无统计学意义(P>0.05)。在随访期间,对照组有3例(5.8%)复发,多模态组无复发病例。结论多模态神经导航系统通过多图像融合和三维重建原理,联合多普勒超声和神经电生理监测,实时引导指示术中病变与邻近神经血管结构的空间关系,提高了岩斜区肿瘤手术的全切率,减少了术后并发症及复发率。多模态神经导航系统的应用为岩斜区肿瘤的治疗效果提供了保障。Objective To explore the clinical application of multimodal neuronavigation system in the resection of petroclival tumors,and to improve the safety of the procedure.Methods Surgical resection of petroclival tumors was performed in 87 cases from January 2013 to January 2019.In 35 patients,surgical resection was carried out with the multimodal neuronavigation system(multimodal group).Fifty-two patients underwent surgical resection without intraoperative imaging guidance(control group).The data related to patients’medical history,imaging examination,tumor resection procedure,preoperative and postoperative neurological function,and postoperative complications were collected and analyzed.Regular follow-up was conducted to record patients’neurological status and quality of life.Results Complete surgical resection was performed in 30 cases(85.7%)in the multimodal group and in 33 cases(63.5%)in the control group.The total shear rate in the multimodal group was significantly higher than that in the control group(P<0.05).Postoperative com-plications were observed in 8 cases(22.9%)in the multimodal group and in 17 cases(32.7%)in the control group.The incidence of post-operative complications in the control group was higher than that in the multimodal group(P>0.05).During the follow-up period,3 cases(5.8%)in the control group showed recurrence,while no recurrence was observed in the multimodal group.Conclusion The multimodal neuronavigation system can improve the total resection rate of petroclival tumors.It can also reduce the postoperative complications and the recurrence rate.The application of a multimodal neuronavigation system may improve the success rate of petroclival tumor treatment.

关 键 词：多模态神经导航系统 三维重建 岩骨-斜坡区 多普勒超声 神经电生理监测 

分 类 号：R651.1[医药卫生—外科学]