术中超声引导脑深部肿瘤切除疗效分析  

Efficacy of intraoperative ultrasonography in detecting and resecting deep-seated brain tumors

作　　者：左赋兴 蔡洪庆 何永昌 苑青 万经海 Zuo Furing;Cai Hongqing;He Yongchang(Department of Neurosurgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院神经外科,北京100021

出　　处：《立体定向和功能性神经外科杂志》2023年第2期90-94,共5页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：中国医学科学院医学与健康科技创新工程项目(编号:2020-I2M-C&T-B-071)。

摘　　要：目的 总结分析术中超声引导下脑深部肿瘤切除的临床经验,以期提高手术疗效,改善疾病预后。方法 回顾24例接受手术治疗的脑深部肿瘤患者临床资料,术中应用超声引导13例(超声组),未使用超声11例(对照组)。个体化选择经非功能区皮层和经脑沟入路显露并切除肿瘤,分析比较两组病例围手术期各项指标。结果 两组患者在年龄、肿瘤大小、病灶深度、术前功能状态评分上均无统计学差异。超声组在显露肿瘤时间、镜下操作时长、术后住院时长、术后三月脑软化灶体积、术后三月患者功能状态评分上均显著优于对照组(P<0.05),且肿瘤全切率较高,术后并发症发生率和术后脑水肿程度较低。结论 术中超声可精准定位脑深部肿瘤,有效弥补了神经导航的不足。超声引导下个体化手术入路有利于节省手术时间、全切肿瘤、保护神经功能、促进康复、改善疾病预后。Objective To assess diagnostic performance of the intraoperative ultrasonography in neuro-oncology practice based on the clinical features of patients with deep-seated brain tumors.Methods A retrospective review of 24 patients who were treated for deeply seated brain tumors has been performed.Among these cases,13 patients underwent tumor resection via dissection of the non-eloquent cortex or trans-sulcal approach depending on the intraoperative ultrasonic findings(ultrasound-guided group),while 11 patients experienced trans-sulcal approach without intraoperative ultrasonography(control group).Data regarding clinical findings and technical considerations were analyzed.Results No statistically significant difference was observed in the age,tumor diameter,depth of the lesions,and preoperative Karnofsky Performance Scale(KPS) of these 2 groups.However,shorter exposure time,less microscopic or endoscopic procedure time,reduced duration of hospitalization,a fewer extent of focal encephalomalacia,and higherKPS 3 months after surgery were all achieved statistical significance in patients in the ultrasound-guided group when compared with the control group(P<0.05).Moreover,the ultrasound-guided surgery provided higher rate of gross total resection,fewer complications,and less degree of postoperative brain edema.Conclusion Intraoperative ultrasonography can accurately identify deeply seated brain tumors,andmay compensate for craniotomy-induced brain-shift.Shortening operation duration,complete tumor resection with minimal invasion,and improved recovery time can be obtained via the ultrasonic-guided surgery,resulting insurvival benefits.

关 键 词：术中超声 脑深部肿瘤 手术入路 

分 类 号：R739.41[医药卫生—肿瘤]