| 术中唤醒麻醉下语言区肿瘤切除术的临床研究 |
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| 引用本文： | 王培栋,马万,陶国才,陈学新,孟尽海,马汉祥.术中唤醒麻醉下语言区肿瘤切除术的临床研究[J].宁夏医科大学学报,2011(5):463-465,469. |
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| 作者姓名： | 王培栋 马万 陶国才 陈学新 孟尽海 马汉祥 |
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| 作者单位： | 宁夏医科大学;宁夏医科大学总医院麻醉科;第三军医大学附属西南医院麻醉科; |
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| 基金项目： | 宁夏回族自治区科技攻关项目(2008080) |
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| 摘 要： | 目的探讨全身麻醉术中唤醒方法行语言区肿瘤切除术的安全性和可行性。方法选择位于大脑语言区肿瘤患者9例，麻醉前一天用焦虑自评量表（SAS）测定患者焦虑状况。对患者进行喉罩通气，罗哌卡因头皮浸润麻醉，丙泊酚和瑞芬太尼靶控输注，间断静脉推注舒芬太尼。术中唤醒后行语言功能监测（指认图片、连续计数），并行唤醒后的警觉／镇静评分（OAA／S）、视觉模拟评分（VAS），再行神经电生理刺激，确定语言区和切除范围。术后随访3个月。结果8例患者麻醉前SAS评分为（45．6±1．7）分，唤醒后OAA／S为（4．8±0．2）分，VAS为（0．7±0．3）分，镇痛完善，完全配合术者要求进行语言功能监测和神经电生理定位语言区。1例患者麻醉前SAS评分为62分，唤醒后OAA／S为2．5分，VAS为8．0分，因唤醒后术中出现癫痫持续发作，放弃唤醒。随访3个月，8例患者功能完全恢复正常，l例存在轻度语言功能障碍。结论在唤醒麻醉下行语言功能监测及神经电生理定位有助于最大程度地切除语言区病灶，提高患者术后生存质量。
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| 关 键 词： | 唤醒麻醉 语言定位 皮质电刺激 靶控输注 |
Clinical Study for Resection of Tumors in Eloquent Cortex under Awake Anesthesia |
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| WANG Pei-dong,MA Wan,TAO Guo-cai,CHEN Xue-xin,MENG Jin-hai,MA Han-xiang.Clinical Study for Resection of Tumors in Eloquent Cortex under Awake Anesthesia[J].Journal of Ningxia Medical College,2011(5):463-465,469. |
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| Authors: | WANG Pei-dong MA Wan TAO Guo-cai CHEN Xue-xin MENG Jin-hai MA Han-xiang |
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| Institution: | WANG Pei-dong1,MA Wan2,TAO Guo-cai3,CHEN Xue-xin2,MENG Jin-hai2,MA Han-xiang2(1.Ningxia Medical University,Yinchuan 750004,2.Department of Anesthesiology,the General Hospital,Ningxia Medical University,3.Department of Anesthesiology,Southwest Hospital,Third Military Medical University,Chongqing 400000) |
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| Abstract: | Objective To discuss the safety and feasibility for resection of tumors in eloquent cortex under wake-up during general anesthesia.Methods A total of 9 cases with tumors in eloquent cortex were selected and the anxiety statuses of the patients were evaluated consulting the Self-Rating Anxiety Scale(SAS)at the day before the operations.Scalp ropivacaine infiltrating anesthesia was used and ventilation by LMA.The certain depth of anesthesia was kept by target controlled infusion of propofol plus remifentanil ... |
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| Keywords: | awake anaesthesia language mapping cortical electrical stimulation target controlled infusion |
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