论文部分内容阅读
目的探讨侵犯运动区的脑胶质瘤手术治疗方法。方法回顾分析12例侵犯中央前回脑胶质瘤病例资料,手术采用神经导航定位病灶和中央前回,术中唤醒麻醉,直接皮质电刺激定位肢体运动或语言运动区,患者清醒状态下切除肿瘤。结果11例术中成功唤醒切除肿瘤,皮质电刺激下7例获得了肢体运动区,2例获得了语言运动区的准确定位。8例(66．7%)达到肿瘤全切除,4例次全切除。8例为低级别胶质瘤,2例为高级别胶质瘤,2例胶质母细胞瘤。术后4例无神经功能缺损,8例出现术后对侧肢体活动障碍或言语障碍,除1例外均在7d至1月内恢复正常。结论导航辅助下的直接皮质电刺激定位功能区和唤醒状态下的肿瘤切除是处理侵犯功能区肿瘤的一种安全、有效的方法,可以获得功能区的准确定位并达到最小程度的功能损伤和最大限度的切除肿瘤。
Objective To investigate the surgical treatment of gliomas in sports area. Methods Retrospective analysis of 12 cases of central glioma before invasion of the data, the use of neurological navigation positioning lesions and the central anterior back, intraoperative wake-up anesthesia, direct cortical stimulation of locomotor activity or locomotor area, the patient under the excision of the tumor. Results In the 11 cases, the tumor was successfully aroused and excised. In 7 cases of cortical electric stimulation, the limb movement area was obtained and in 2 cases the accurate localization of the language movement area was obtained. Eight cases (66.7%) achieved total tumor resection and four cases underwent total excision. 8 cases were low grade gliomas, 2 cases were high grade gliomas and 2 cases were glioblastoma. There were no neurological deficits in 4 cases and 8 cases of contralateral limb movement disorder or verbal dysfunction after operation. Except for 1 case, all recovered to normal within 7 days to 1 month. Conclusions Direct navigation with the aid of cortical stimulation and tumor resection is a safe and effective method to deal with the invasion of tumor in the functional area, which can obtain the accurate positioning of the functional area with minimal functional impairment and maximum Limit the removal of the tumor.