【摘要】：背景:隨著科學(xué)技術(shù)近幾十年的迅猛發(fā)展,神經(jīng)外科也隨之發(fā)展,手術(shù)逐漸由原來(lái)的傳統(tǒng)開(kāi)顱手術(shù)朝著向顯微手術(shù)發(fā)展,手術(shù)方案更加精細(xì)化,個(gè)體化。為了達(dá)到以最小的損傷將病損切除,并能保護(hù)患者安全和神經(jīng)功能。精準(zhǔn)定位已成為手術(shù)成功與否的關(guān)鍵。在術(shù)中CT,術(shù)中MRI尚未普及的情況下,術(shù)中實(shí)時(shí)超聲對(duì)顱內(nèi)病變的定位與監(jiān)測(cè)具有重要作用。目的:本實(shí)驗(yàn)通過(guò)對(duì)40例顱內(nèi)病變患者在手術(shù)中實(shí)行術(shù)中超聲實(shí)時(shí)監(jiān)測(cè)與定位和對(duì)患者術(shù)后超早期進(jìn)行康復(fù)治療,總結(jié)患者術(shù)后的恢復(fù)情況。評(píng)估與評(píng)價(jià)術(shù)中實(shí)時(shí)超聲對(duì)顱內(nèi)病變定位與監(jiān)測(cè)的運(yùn)用價(jià)值。方法:選取2013年11月份至2015年9月份近兩年來(lái),在安徽醫(yī)科大學(xué)第一附屬醫(yī)院神經(jīng)外科門診就診并住院治療的40例顱內(nèi)病變患者,通過(guò)搜集并分析患者術(shù)前影像學(xué),術(shù)中超聲圖片,術(shù)后病理,術(shù)后并發(fā)癥和術(shù)后對(duì)患者早期心理疏通,早期康復(fù)等治療后的相關(guān)隨訪資料,評(píng)價(jià)術(shù)中實(shí)時(shí)超聲對(duì)顱內(nèi)病變定位與監(jiān)測(cè)的運(yùn)用價(jià)值。結(jié)果:40例顱內(nèi)病變患者在經(jīng)過(guò)術(shù)中實(shí)時(shí)超聲實(shí)時(shí)定位與監(jiān)測(cè)下切除顱內(nèi)病變,術(shù)中實(shí)時(shí)超聲均能準(zhǔn)確定位病變,了解病變性質(zhì)與周圍解剖情況;術(shù)后未見(jiàn)再出血,顱內(nèi)感染,明顯水腫與梗死等并發(fā)癥,患者術(shù)前出現(xiàn)的偏癱及失語(yǔ)等癥狀在術(shù)中實(shí)時(shí)超聲監(jiān)測(cè)下切除病變后有不同程度的好轉(zhuǎn),40例患者喪失的神經(jīng)功能得到迅速恢復(fù)或一定程度的改善,從而提高了患者的生存質(zhì)量,具有重大的社會(huì)價(jià)值。結(jié)論:術(shù)中實(shí)時(shí)超聲定位精確,使用簡(jiǎn)便安全,在顱內(nèi)病變切除中具有監(jiān)測(cè)病變與重要血管神經(jīng)等重要作用,降低患者出現(xiàn)嚴(yán)重并發(fā)癥的概率,提高患者術(shù)后的生存質(zhì)量,具有重大的社會(huì)價(jià)值,在術(shù)中CT,術(shù)中MRI尚未普及的情況下,值得推廣。
[Abstract]:Background: with the rapid development of science and technology in recent decades, neurosurgery has also developed. Surgery has gradually moved from traditional craniotomy to microsurgery, and the operation plan is more refined and individualized. In order to minimize the injury to remove the lesion, and to protect the patient's safety and neurological function. Accurate positioning has become the key to the success of the operation. The intraoperative real-time ultrasound plays an important role in the localization and monitoring of intracranial lesions when MRI is not widely used in intraoperative CT,. Objective: to summarize the postoperative recovery of 40 patients with intracranial lesions by real-time monitoring and localization of intraoperative ultrasound and rehabilitation therapy in the early stage after operation. To evaluate the value of intraoperative real-time ultrasound in the localization and monitoring of intracranial lesions. Methods: from November 2013 to September 2015, 40 patients with intracranial lesions who were admitted to the Department of Neurosurgery, the first affiliated Hospital of Anhui Medical University, were collected and analyzed. In order to evaluate the value of intraoperative real-time ultrasound in the localization and monitoring of intracranial lesions, ultrasound images during operation, postoperative pathology, postoperative complications, early psychological dredging and early rehabilitation of patients were evaluated. Results 40 cases of intracranial lesions were resected by real-time ultrasonic localization and monitoring during operation. Real-time ultrasound could accurately locate the lesions, understand the nature of the lesions and the surrounding anatomy, and there was no rebleeding and intracranial infection after operation. The symptoms of hemiplegia and aphasia before operation were improved in different degree after real-time ultrasound monitoring. The neurological function of 40 patients was recovered quickly or improved to a certain extent. Thus, the quality of life of patients is improved and has great social value. Conclusion: the intraoperative real-time ultrasound localization is accurate, the use is simple and safe, it has the important function of monitoring the pathological changes and important vessels and nerves in the excision of intracranial lesions, so as to reduce the probability of serious complications and improve the quality of life of the patients after operation. It has great social value and is worth popularizing when MRI is not popularized in intraoperative CT,.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R651.1

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