多模态神经导航联合术中超声及荧光素钠引导高级别胶质瘤精准切除  

Guided precision resection of high-grade gliomas using multimodal neuronavigation integrated with intraoperative ultrasound and sodium fluorescein

作　　者：王忠 周志彪 张晓军 张瑞剑 韩志桐 赵卫平 杨文博 邢栋 王俊青 杨蔚然 王飞 宋钰辉 WANG Zhong;ZHOU Zhibiao;ZHANG Xiaojun;ZHANG Ruijian;HAN Zhitong;ZHAO Weiping;YANG Wenbo;XING Dong;WANG Junqing;YANG Weiran;WANG Fei;SONG Yuhui(Department of Neurosurgery,Inner Mongolia People s Hospital,Hohhot 010017,China)

机构地区：[1]内蒙古自治区人民医院神经外科,呼和浩特010017 [2]乌兰察布市中心医院神经外科

出　　处：《临床神经外科杂志》2025年第2期158-165,共8页Journal of Clinical Neurosurgery

基　　金：内蒙古自治区卫健委科技计划项目(202201059);内蒙古医科大学联合项目(YKD2023LH082);内蒙古自治区人民医院院内基金项目(2019YN04);内蒙古自治区医师协会临床医学研究和临床新技术推广项目(YSXH2024KYF005)。

摘　　要：目的 通过将多模态功能神经导航影像融合技术与术中荧光素钠引导技术及术中超声技术进行联合,探究其在高级别胶质瘤切除手术中的应用价值。方法 收集2018年1月—2024年2月于内蒙古自治区人民医院就诊并使用多模态功能神经导航及超声技术行颅内高级别胶质瘤切除的98例患者的临床资料,采用随机数字表法将患者随机分为观察组和对照组,每组各49例。对照组使用多模态功能神经导航及术中超声技术行颅内高级别胶质瘤切除,观察组使用多模态功能神经导航及术中超声技术联合术中荧光素钠行颅内高级别胶质瘤切除,对两组患者术后肿瘤切除程度、术后肌力改善情况、术后有无并发症、有无新发神经功能障碍、手术时间等指标进行统计学比较。结果 两组患者在性别、年龄、肿瘤部位、病理分级等资料上无统计学意义(P>0.05)。观察组肿瘤全切除率(91.84%)明显高于对照组肿瘤全切除率(75.51%),其差异具有统计学意义(χ^(2)=4.781,P=0.029);观察组术后肌力改善情况高于对照组,其差异具有统计学意义(χ^(2)=6.498,P=0.011);术后新发功能障碍观察组低于对照组,其差异具有统计学意义(χ^(2)=4.346,P=0.037),术后并发症发生率观察组与对照组无统计学意义(χ^(2)=1.333,P=0.248),观察组手术时间相较于对照组减少,其差异有统计学意义(t=2.621,P=0.010)。结论 多模态功能神经导航影像融合技术联合术中荧光素钠及术中超声技术用于颅内高级别胶质瘤切除能清楚地辨别肿瘤组织与正常脑组织的位置关系,可在保护重要血管、神经、传导束的基础上达到对胶质瘤组织的最大程度切除,并明显降低神经系统损伤,减少术后并发症,改善患者预后。Objective To investigate the value of multimodal functional neuronavigation image fusion in conjunction with intraoperative fluorescein sodium and intraoperative ultrasound in high-grade glioma resection.Methods The clinical data of 98 patients treated from January 2018 to February 2024 who underwent resection of high-grade intracranial glioma using multimodal functional neuronavigation and intraoperative ultrasound were collected and randomly divided into observation group and control group by random comparison table method,with 49 cases in each group.The control group was given multimodal functional neuronavigation and intraoperative ultrasound to perform high-grade intracranial glioma resection.The observation group was given multimodal functional neuronavigation and intraoperative ultrasound combined with intraoperative fluorescein sodium to perform high-grade intracranial glioma resection.The postoperative tumor resection extent,improvement of postoperative muscle strength,postoperative complications,new neurological dysfunction and operation time were statistically compared between the two groups.Results Through the summary of the original data,there was no statistical significance in gender,age,tumor location,pathological grade and other data between the observation group and the control group(P>0.05),and the data were comparable.The results showed that the total tumor resection rate in the observation group(91.84%) was significantly higher than that in the control group(75.51%),and the difference was statistically significant(χ~2= 4.781,P= 0.029).The improvement of muscle strength in the observation group was significantly higher than that in the control group(χ~2= 6.498,P= 0.011).The incidence of postoperative new dysfunction in the observation group was lower than that in the control group,and the difference was statistically significant(χ~2= 4.346,P= 0.037).The incidence of postoperative intracranial infection complication was not statistically significant between the observation group and the contr

关 键 词：多模态影像融合 神经导航 荧光素钠 术中超声 高级别胶质瘤 

分 类 号：R739.41[医药卫生—肿瘤]