神经导航技术在颅脑肿瘤手术中的应用  

Application of Neuronavigation Technology in Craniocerebral Tumor Surgery

作　　者：骆承章 蒋敏杰[1] 吴小明[1] 蒋宽 蒋建刚[1] LUO Chengzhang;JIANG Minjie;WU Xiaoming;JIANG Kuan;JIANG Jiangang(Department of Neurosurgery,Yixing People's Hospital,Yixing,Jiangsu Province,214200 China)

机构地区：[1]宜兴市人民医院神经外科,江苏宜兴214200

出　　处：《中外医疗》2021年第22期6-9,共4页China & Foreign Medical Treatment

基　　金：无锡市卫生健康委科研青年项目(Q201940)。

摘　　要：目的探讨神经导航技术在脑肿瘤切除手术过程中的应用价值。方法回顾性分析2016年1月—2020年8月宜兴市人民医院神经外科收治手术的65例脑肿瘤患者的临床资料,其中19例患者经神经导航辅助,并在显微镜下行脑肿瘤切除术,作为观察组,将其余46例术中未使用神经导航的患者作为对照组,行常规显微镜下肿瘤切除术。比较两组患者手术时间、术后住院时间、术中肿瘤全切率、致残率、术后颅内感染发生率以及术后Karnofsky功能状态(KPS)评分。结果对比分析显示,观察组脑肿瘤全切率要显著高于对照组(78.9%vs 52.2%),差异有统计学意义(χ^(2)=4.016,P<0.05);观察组术后住院时间(18.79±3.32)d明显短于对照组(23.02±8.48)d,差异有统计学意义(t=2.889,P<0.05);术后KPS评分观察组及对照组的中位数及四分位数分别为90(90,100)分及90(70,90)分,术后KPS评分观察组显著高于对照组,差异有统计学意义(Z=-2.433,P<0.05)。两组之间在手术时间、手术致残率、术后感染发生率以及术前KPS评分的差异无统计学意义(P>0.05)。结论与传统开颅手术相比较,神经导航辅助技术能够提高开颅手术过程中定位的精准度,增加肿瘤全切机率,并提高患者术后KPS评分,减少了对患者术后生活质量的影响,具有明确的临床应用价值。Objective To explore the application value of neuronavigation technology in brain tumor resection.Methods A retrospective analysis of the clinical data of 65 patients with brain tumors admitted to the department of neurosurgery of Yixing People’s hospital from January 2016 to August 2020.Among them,19 patients were assisted by neuronavigation and underwent brain tumor resection under a microscope,as the observation group,the remaining 46 patients who did not use neuronavigation during the operation were used as the control group and underwent conventional tumor resection under the microscope.The operation time,postoperative hospital stay,intraoperative tumor resection rate,disability rate,postoperative intracranial infection rate,and postoperative karnofsky functional status(KPS)score were compared between the two groups.Results Comparative analysis showed that the total resection rate of brain tumors in the observation group was significantly higher than that in the control group(78.9%vs 52.2%),and the difference was statistically significant(χ^(2)=4.016,P<0.05);postoperative hospital stay in the observation group(18.79±3.32)d was significantly shorter than the control group(23.02±8.48)d,the difference was statistically significant(t=2.889,P<0.05);the median and quartile of KPS score observation group and control group were respectively 90(90,100)and 90(70,90).The KPS score of the observation group was significantly higher than that of the control group,and the difference was statistically significant(Z=-2.433,P<0.05).There was no statistically significant difference between the two groups in operation time,surgical disability rate,postoperative infection rate,and preoperative KPS score(P>0.05).Conclusion Compared with traditional craniotomy,neuronavigation assisted technology can improve the accuracy of positioning during craniotomy,increase the probability of total tumor resection,and improve the KPS score of patients after surgery,and reduce the impact on the quality of life of patients after surgery.It

关 键 词：神经导航 脑肿瘤 显微外科手术 

分 类 号：R5[医药卫生—内科学]