磁共振弥散张量和B超在胶质瘤切除术中的应用

目的　探讨在胶质瘤切除术中使用磁共振弥散张量联合B超的临床效果。方法　选取2020年1月至2021年11月佳木斯市中心医院收治的低级别胶质瘤患者共35例，其中男18例、女17例，年龄（36.9±2.2）岁，应用磁共振弥散张量和B超进行实时引导进行手术。另选取同期进行常规胶质瘤切除术的35例患者进行对照比较（设为对照组），其中男16例、女19例，年龄（37.2±2.3）岁。观察两组患者的手术时间、术中出血量、住院时间、肿瘤定位准确率、手术全切除率以及术后并发症，采用日常生活活动能力（Activities of Daily Living，ADL）量表、Karnofsky功能状态（KPS）评分评价两组患者的生活质量及健康状况。组间计数和计量资料的比较分别采用χ²检验和t检验。结果　观察组胶质瘤患者的手术时间［（174.6±16.4）min］、术中出血量［（42.3±10.7）ml］、住院时间［（10.2±2.4）d］均少于对照组［（220.3±18.3）min、（65.2±9.4）ml、（16.4±3.2）d］，肿瘤定位准确率为91.42%（32/35）、全切率为88.57%（31/35），均高于对照组［65.71%（23/35）、62.86%（22/35）］，差异均有统计学意义（均P<0.05）。两组患者的术后并发症发生率比较，差异无统计学意义（P>0.05）。手术前，两组患者ADL、KPS评分差异均无统计学意义（均P>0.05）；手术后，两组患者ADL、KPS评分均显著升高，观察组ADL评分为（74.3±3.6）分、KPS为（64.6±7.8）分，均高于对照组的（62.5±4.6）分、（60.7±7.4）分，差异均有统计学意义（t=8.142、2.146，均P<0.05）。结论　对胶质瘤手术患者进行磁共振弥散张量联合B超的应用，手术定位精准，能够有效降低术中出血，提高手术效率以及精确度，减少住院时间，提高自主活动能力和生活质量。

Application of magnetic resonance DTI and B ultrasound in gliomaresection

Objective　To investigate the clinical effect of magnetic resonance diffusiontensor combined with B-ultrasound in glioma resection. Methods　A total of 35 patients with low-grade glioma who were treated in JiamusiCentral Hospital from January 2020 to November 2021, including 18 males and 17females who were (36.9±2.2) years old, were selected as an observation group.Resonance diffusion tensor and B-ultrasound were used for real-time guidance inthe surgery for the observation group. And 35 patients who underwentconventional glioma resection during the same period were selected as a controlgroup, including 16 males and 19 females who were (37.2±2.3) years old. Theoperation times, intraoperative blood loss, hospital stays, tumor localizationaccuracies, total surgical resection rates, and postoperative complicationswere compared between the two groups. Activities of Daily Living (ADL) scaleand Karnofsky Performance Status (KPS) were used to evaluate the quality oflife and health status of the two groups. The comparison of enumeration dataand measurement data between the two groups was performed using χ² and t tests. Results　The operation time,intraoperative blood loss, and hospital stay in the observation group were lessthan those in the control group [(174.6±16.4) min vs. (220.3±18.3) min,(42.3±10.7) ml vs. (65.2±9.4) ml, and (10.2±2.4) d vs. (16.4±3.2) d], and thetumor localization accuracy and complete resection rate were higher than thosein the control group [91.42% (32/35) vs. 65.71% (23/35) and 88.57% (31/35) vs.62.86% (22/35)], with statistical differences (all P<0.05). There was no statistical difference in the incidence ofpostoperative complications between the two groups (P>0.05). Before the surgery, there were no statisticaldifferences in the scores of ADL and KPS between the two groups (both P>0.05). After the surgery, thescores of ADL and KPS were significantly higher than those before the surgeryin both groups, and were higher in the observation group than in the controlgroup [(74.3±3.6) vs. (62.5±4.6) and (64.6±7.8) vs. (60.7±7.4)], withstatistical differences (t=8.142 and2.146, both P<0.05). Conclusion　The application ofmagnetic resonance diffusion tensor and B-ultrasound in patients taking gliomasurgery has accurate surgical positioning, and can effectively reduceintraoperative bleeding and hospitalization time and improve surgicalefficiency, accuracy, autonomous activity, and quality of life