多模态神经导航系统联合神经内镜在颅咽管瘤手术中的临床应用  

Clinical application of multimodal neuronavigation system assisted neuroendoscopy in craniopharyngioma surgery

作　　者：赵君爽 李龙[1] 陈炼 周锦鹏[1] 景治涛[1] ZHAO Jun-shuang;LI Long;CHEN Lian(Department of Neurosurgery,the First Affiliated Hospital of 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,沈阳110001

出　　处：《临床神经外科杂志》2020年第4期413-416,共4页Journal of Clinical Neurosurgery

基　　金：辽宁省自然科学基金(20170541022);辽宁省“百千万人才工程”资助项目(2019-B45)。

摘　　要：目的探讨多模态神经导航系统联合神经内镜手术治疗颅咽管瘤的临床效果及安全性,寻找颅咽管瘤手术治疗的最佳策略。方法回顾性分析中国医科大学附属第一医院神经外科2017年1月—2019年1月在多模态神经导航系统辅助下经鼻神经内镜切除颅咽管瘤的18例患者的临床资料。分析患者的肿瘤切除程度及术后并发症。结果16例患者(88.9%)的肿瘤完全切除,2例患者(11.1%)的肿瘤次全切除。6例患者(33.3%)术后出现并发症,其中脑脊液鼻漏1例、尿崩症2例、发热1例、低血钠1例、甲状腺功能下降1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,联合术中多普勒超声和神经电生理监测实时显示病变与邻近血管、神经的空间关系,提高了颅咽管瘤的全切率,减少了术后并发症的发生率。多模态神经导航系统联合神经内镜在颅咽管瘤手术中的应用显著改善了手术效果,并为颅咽管瘤的手术治疗提供了更好的保障。Objective To explore the clinical application of multimodal neuronavigation system assisted neuroendoscopy in craniopharyngioma surgery.To improve the safety and effectiveness of surgical resection of craniopharyngioma,and to find the best strategy for surgical treatment of craniopharyngioma.Methods The clinical data of 18 patients who underwent surgical resection of craniopharyngioma by nasal neuroendoscopic surgery assisted by multi-modal neuronavigation system in the Department of Neurosurgery,the First Affiliated Hospital of China Medical University from January 2017 to January 2019 were analyzed retrospectively.The surgical resection extent and postoperative complications were analyzed.Results The tumor was completely removed in 16 patients(88.9%),and postoperative complications occurred in 6(33.3%),including 1 of postoperative cerebrospinal fluid rhinorrhea,2 of diabetes insipidus,1 of fever,1 of postoperative ion disorder(hyponatremia),and 1 of decreased thyroid function.Conclusions Based on the principle of multi-image fusion and three-dimensional reconstruction,the multimodal neuronavigation system combined Doppler ultrasound and neuroelectrophysiological monitoring to indicate the spatial relationship between intraoperative lesions and adjacent blood vessels and nerves in real-time guided operation.The total resection rate of craniopharyngioma is improved and the incidence of postoperative complications is reduced.The application of multimodal neuronavigation system combined with neuroendoscopy in craniopharyngioma surgery has significantly improved the surgical results and provided a better guarantee for the surgical treatment of craniopharyngioma.

关 键 词：多模态神经导航系统 颅咽管瘤 神经内镜 多普勒超声 神经电生理监测 

分 类 号：R651.1[医药卫生—外科学]