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唤醒麻醉结合皮层电刺激下切除皮层语言区病变21例临床分析
引用本文:张金鹏,刘耀,李旭辉,吴国瑞,角述兰,赵宁辉.唤醒麻醉结合皮层电刺激下切除皮层语言区病变21例临床分析[J].国际神经病学神经外科学杂志,2014,41(6):526-528.
作者姓名:张金鹏  刘耀  李旭辉  吴国瑞  角述兰  赵宁辉
作者单位:昆明医科大学第二附属医院;
基金项目:云南省中青年学术技术带头人后备人才(2009c1034);云南省卫生厅卫生系统学科带头人(D-201221)
摘    要:目的探讨唤醒麻醉结合皮层电刺激开颅手术切除语言功能区病变的价值。方法回顾性分析21例唤醒麻醉结合皮层下电刺激开颅手术术前准备、术中过程、术后康复等临床资料,所有病变均位于或紧邻语言功能区,病人均实施唤醒麻醉,术中先用双极电刺激器确定语言功能区,在确定的语言功能区外1cm,最大范围切除病变。结果病变全切17例(80.95%),次全切4例(19.05%)。术后短期运动性失语1例(4.76%),术中癫痫1例(4.76%),术后颅内血肿1例(4.76%)。远期复发2例,均为胶质瘤次全切除病人(9.52%),余患者恢复良好。结论唤醒开颅结合皮层电刺激手术可最大范围切除语言功能区病变,保护患者言语功能。

关 键 词:唤醒麻醉  皮质电刺激  语言功能区  胶质瘤  海绵状血管瘤
收稿时间:2014/8/17 0:00:00
修稿时间:2014/10/28 0:00:00

Craniotomy directed by awake anesthesia combined with cortical electrical stimulation in resection of lesions in cortical language areas: a clinical analysis of 21 cases
Zhang Jin-Peng,Liu Yao,Li Xu-Hui,Wu Guo-Rui,Jiao Shu-Lan,Zhao Ning-Hui.Craniotomy directed by awake anesthesia combined with cortical electrical stimulation in resection of lesions in cortical language areas: a clinical analysis of 21 cases[J].Journal of International Neurology and Neurosurgery,2014,41(6):526-528.
Authors:Zhang Jin-Peng  Liu Yao  Li Xu-Hui  Wu Guo-Rui  Jiao Shu-Lan  Zhao Ning-Hui
Institution:The second Affiliated hospital, KunMing medical University, Kunming Yunnan 650101, China
Abstract:

Objective To investigate the value of craniotomy directed by awake anesthesia combined with cortical electrical stimulation in the resection of the lesions in cortical language areas.Methods A total of 21 patients whose lesions were located in or near cortical language areas were admitted to our hospital from August 2011 to December 2013. They were given craniotomy directed by awake anesthesia combined with cortical electrical stimulation. All lesions were resected under awake anaesthesia. The cortical language areas were identified by intraoperative cortical electrical stimulation (bipolar), and then the lesions were resected as completely as possible. Their clinical data such as preoperative preparation, intraoperative process, postoperative rehabilitation were retrospectively analyzed.Results Total tumor resection was achieved in 17 (80.95%) out of 21 patients, and subtotal resection was performed in 4 patients (19.05%). One case (4.76%) was found to have motor aphasia during the first two weeks of follow-up, epilepsy occurred in one person (4.76%) during the operation, and intracranial hematoma occurred in one patient (4.76%) after the operation. The gliomas of two patients (9.52%) who had used subtotal tumor resection recurred. The other patients had good clinical outcomes.Conclusions The lesions in cortical language areas can be resected by the craniotomy directed by awake craniotomy combined with cortical electrical stimulation to the utmost extent, and the language function can be protected effectively.

Keywords:

Awake anesthesia|Cortical electrical stimulation|Cortical language areas|Glioma|Cavernous angioma

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