术中超声引导脑深部海绵状血管畸形手术的疗效分析  

Analysis of the effect of intraoperative ultrasound-guided surgery for deep-seated cerebral cavernous vascular malformation

作　　者：骆慧[1] 刘宁[1] 尤永平[1] 王彬彬[1] LUO Hui;LIU Ning;YOU Yongping;WANG Binbin(Department of Neurosurgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院神经外科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2022年第5期696-701,共6页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金(81872058)。

摘　　要：目的:探讨术中超声引导脑深部海绵状血管畸形切除的技术要点和临床疗效。方法:回顾性分析45例位于端脑或小脑深部的海绵状血管畸形患者资料,按术中是否使用超声引导分为超声组(26例)和对照组(19例)。记录患者一般资料以及超声影像;对比两组患者病变的直径、深度、显微镜下操作时间、住院天数;对比两组患者术前、术后1周以及术后3个月的卡氏功能状态(Karnofsky performance status,KPS)评分情况。结果:脑深部海绵状血管畸形和周边组织结构具有典型的超声影像学特征。基于两组分别在病变直径、深度以及术前KPS评分等大致相同的临床背景下(P>0.05),对比发现超声组在显微镜下操作时间[(41.69±8.04)min]、术后住院天数[(6.92±1.57)d]以及术后1周的KPS评分[(65.38±7.60)分]方面明显优于对照组[(50.74±8.52)min、(8.68±2.89)d、(58.42±10.68)分],且差异有统计学意义(P<0.05),然而两组在术后3个月的KPS评分方面,并没有表现出统计学差异[(88.46±8.34)分vs.(87.36±12.84)分,P>0.05]。结论:术中超声清晰显示海绵状血管畸形的特点可以用于协助手术径路的规划与实施,并且通过术中动态实时地引导术者快速、精准地抵达病灶,从而缩短手术时间和住院周期,提高手术疗效,促进患者快速康复。Objective:This study aims to investigate the technical nuances and clinical effects of intraoperative ultrasonic-guided resection of deep-seated intracranial cavernous malformation.Methods:The clinical data of 45 patients with cavernous vascular malformation were retrospectively analyzed and divided into the ultrasound-guided group(26 cases)and control group(19 cases)according to whether ultrasound guidance was used during operation.General information and ultrasound images were recorded.The diameter and depth of each case,operation time under the microscope,and hospitalization period of the two groups were compared.KPS scores were compared between the two groups before surgery,one week after surgery,and three months after surgery,respectively.Results:Deep-seated cavernous malformations and surrounding structures had typical ultrasonic imaging characteristics.The two groups had a similar clinical backgrounds in diameter,depth,and preoperative KPS score(P>0.05).Compared with the control group,the operation time under the microscope(41.69±8.04)min,hospitalization period(6.92±1.57)d,and KPS score(65.38±7.60)one week after operation in the ultrasound group were significantly decreased[(50.74±8.52)min,(8.68±2.89)d,(58.42±10.68)分,P<0.05].However,there was no statistical difference in KPS scores three months after surgery between the two groups[(88.46±8.34)vs.(87.36±12.84)P>0.05].Conclusion:Ultrasound can help to reach the lesion quickly and accurately,thus shortening the operation time and hospitalization period,improving the surgical efficacy,and promoting the rapid recovery of patients.

关 键 词：脑深部海绵状血管畸形 术中超声 神经导航 

分 类 号：R651.1[医药卫生—外科学]