术中B超联合神经电生理监测在中央区病变切除术中的应用

目的 探讨联合应用B超及神经电生理监测在中央区病变切除术中的效果。 方法 回顾性分析36例中央区病变患者的病例资料,术中均联合应用B超及神经电生理监测。行神经电生理监测确定脑中央沟位置,根据B超显示肿瘤位置、大小、血运及周边血流情况,指导手术入路设计,显微镜下切除病灶,术后即时行彩超复查。 结果 36例均行神经电生理监测,均在术中超声定位引导下进行显微手术切除。术后MRI显示,病变切除程度满意,神经上皮性肿瘤12例中,全切除9例,次全切除3例; 非神经上皮性肿瘤24例均全切除。全组无手术死亡病例,患者术后一般情况均得到改善,术前肌力下降的15例患者均较术前明显恢复,手术疗效满意。 结论 术中联合应用B超及神经电生理监测技术,有利于大脑中央区病变的切除,减少脑组织损伤,且简单便捷、安全有效、费用较低。

Application of Intraoperative Ultrasonic B Combined with Neurophysiological Monitoring in Surgical Resection of Lesions Located at the Cerebral Region

Objective To evaluate the effect of combined application of ultrasonic B and neurophysiological monitoring in the lesion excision of central region. Methods 36 cases of lesion in central region were analyzed retrospectively and ultrasonic B and neurophysiological monitoring were jointly used in the operation. Neurophysiological monitoring was carried out to determine the position of central sulcus of brain. According to the position, size, blood supply and blood flow around the tumor displayed in ultrasonic B, the operation sequence was designed, the focus was cut down under the microscopic, and color ultrasound was applied after operation for review. Rusults Microsurgical resection was performed in the 36 cases guided by the technique of intraoperative ultrasonic B combined with neurophysiological monitoring. MRI after operation showed that the degree of resection was satisfactory. In 12 cases of neuroepithelial neoplasms, 9 cases were completely removed and 3 cases were subtotal. In 24 cases of non-neuroepithelial neoplasm, the tumors were removed totally. There was no surgical death case. The general condition of the patients was improved after operation. The muscle strength recovered significantly in the 15 patients with decreased muscle strength postoperatively, the therapeutic effects were satisfactory. Conclusions The technique of intraoperative ultrasonic B combined with neurophysiological monitoring is suitable for surgical resection of lesions located at the cerebral central region, including neuro-epithelial tumor, metastatic tumors and cerebrovascular malformation. The technique is simple, convenient, safe, effective and low cost.