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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,术中唤醒麻醉,直接皮层电刺激定位肢体运动或语言运动区,病人清醒状态下切除肿瘤。结果11例病人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7天至1月内恢复正常。结论导航辅助下的直接皮层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。
Objective To investigate the surgical treatment of gliomas in sports area. Methods Retrospective analysis of 12 cases of invasion of central anterior glioma cases data, the operation of nerve navigation positioning lesions, intraoperative awakening anesthesia, direct cortical stimulation of limb movement or locomotor area, the patient sober state resection of the tumor. Results In the 11 patients, the tumor was successfully aroused and excised during operation. In 7 cases of cortical electrical stimulation, 2 cases of limb movement area were obtained, and the accurate localization of speech 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 dysmotility or verbal dysfunction after operation. All cases recovered to normal within 7 days to 1 month except 1 case. Conclusion Navigation-assisted direct cortical stimulation and tumor resection are the safe and effective methods to treat the tumor infiltrating the functional area.