【摘要】：[目的]探討術(shù)中超聲在顱內(nèi)海綿狀血管瘤顯微外科切除中的應(yīng)用。[方法]回顧性分析2014年11月至2016年9月昆明醫(yī)科大學(xué)第一附屬醫(yī)院神經(jīng)外科手術(shù)治療25例顱內(nèi)海綿狀血管瘤患者的臨床資料,所有患者應(yīng)用術(shù)中超聲進(jìn)行病變定位,并在術(shù)中超聲的實(shí)時(shí)輔助下切除病變,判斷病變的切除程度。術(shù)后觀察患者病變切除率、神經(jīng)系統(tǒng)功能恢復(fù)及并發(fā)癥發(fā)生率等情況。[結(jié)果]本組25例顱內(nèi)海綿狀血管瘤患者術(shù)中超聲均能對(duì)病變顯示良好,定位準(zhǔn)確。所有患者在術(shù)中超聲輔助下均完全切除病變,病變?nèi)新蕿?00%,無(wú)術(shù)中超聲掃描導(dǎo)致的腦挫裂傷、出血等并發(fā)癥,無(wú)感染、死亡病例,術(shù)后病理結(jié)果均為海綿狀血管瘤。術(shù)后25例患者臨床癥狀、體征均較前明顯好轉(zhuǎn),無(wú)出現(xiàn)新的神經(jīng)功能障礙。10例頭疼患者癥狀基本消失,4例神經(jīng)功能障礙患者均完全恢復(fù)正常,11例癲癇患者中,9例已完全治愈,無(wú)需口服抗癲癇藥物,2例口服抗癲癇藥物可完全控制。復(fù)查頭顱MRI均未見(jiàn)病變復(fù)發(fā)。[結(jié)論]術(shù)中超聲是一種安全的、非放射性的成像技術(shù),使用簡(jiǎn)便,操作靈活。術(shù)中超聲可清晰顯示顱內(nèi)海綿狀血管瘤的形態(tài)學(xué)和解剖學(xué)細(xì)節(jié)及其與毗鄰結(jié)構(gòu)的空間關(guān)系,可對(duì)顱內(nèi)海綿狀血管瘤進(jìn)行準(zhǔn)確的定位和判定邊界,為術(shù)者選擇皮層探查切口、顯微切除腫瘤及判斷腫瘤殘留等方面提供了有價(jià)值的信息,協(xié)助和引導(dǎo)手術(shù)進(jìn)程,從而大大增加了腫瘤切除率,減少腦組織損傷,縮短手術(shù)時(shí)間,提高手術(shù)治療效果。隨著更小、更精確的超聲探頭與三維超聲、超聲造影、彩色多普勒血流成像等技術(shù)有效地結(jié)合,術(shù)中超聲對(duì)判斷腫瘤邊界、血流供應(yīng)等方面取得較大進(jìn)步,具有廣闊的臨床應(yīng)用前景和價(jià)值。
[Abstract]:Objective to explore the application of intraoperative ultrasound in microsurgical resection of intracranial cavernous angioma. [methods] the clinical data of 25 patients with intracranial cavernous angioma treated by neurosurgery in the first affiliated Hospital of Kunming Medical University from November 2014 to September 2016 were analyzed retrospectively. all patients were located by intraoperative ultrasound and resected with the real-time assistance of intraoperative ultrasound to judge the degree of resection. After operation, the resection rate of lesion, the recovery of nervous system function and the incidence of complications were observed. [results] Intraoperative ultrasound could display the lesions well and locate accurately in 25 patients with intracranial cavernous angioma. All the patients were completely resected with the assistance of intraoperative ultrasound, and the total resection rate was 100%. There were no complications such as cerebral contusion and laceration and hemorrhage caused by intraoperative ultrasound scan, no infection, death and postoperative pathological results were cavernous angiomas. The clinical symptoms and signs of 25 patients were significantly improved after operation, and there was no new neurological dysfunction. The symptoms of 10 patients with headache basically disappeared, 4 patients with neurological dysfunction completely returned to normal. Among the 11 epileptic patients, 9 cases were completely cured, no oral antiepileptic drugs were needed, and 2 cases were completely controlled by oral antiepileptic drugs. No recurrence of lesions was found on MRI. [conclusion] Intraoperative ultrasound is a safe and non-radioactive imaging technique, which is simple to use and flexible to operate. Intraoperative ultrasound can clearly display the morphological and anatomical details of intracranial cavernous angioma and its spatial relationship with adjacent structures, accurately locate and determine the boundary of intracranial cavernous angioma, provide valuable information for operators to select cortical exploration incision, microscopic resection of tumor and judge tumor residue, assist and guide the surgical process, thus greatly increasing tumor resection rate and reducing brain tissue injury. Shorten the operation time and improve the effect of operation. With the effective combination of smaller and more accurate ultrasound probe with three-dimensional ultrasound, contrast-enhanced ultrasound and color Doppler flow imaging, intraoperative ultrasound has made great progress in judging tumor boundary and blood flow supply, which has broad clinical application prospect and value.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R651.12

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 王意達(dá);王涌;毛穎;王怡;;術(shù)中超聲標(biāo)準(zhǔn)切面聲像圖在輔助顱腦病灶切除中的應(yīng)用價(jià)值[J];腫瘤影像學(xué);2016年03期

2 陳彤;郭亮;;顱內(nèi)海綿狀血管瘤的影像特點(diǎn)及治療分析[J];影像診斷與介入放射學(xué);2016年03期

3 張家良;周思超;從林;;顱內(nèi)海綿狀血管瘤的臨床特點(diǎn)影像學(xué)及治療分析[J];中國(guó)實(shí)用神經(jīng)疾病雜志;2015年11期

4 張劍寧;;顱內(nèi)海綿狀血管瘤治療的爭(zhēng)議與探討[J];中華神經(jīng)外科疾病研究雜志;2014年01期

5 賀焱;何文;林松;宮麗杰;劉春鶴;張春玲;;術(shù)中超聲在顱腦深部腫瘤術(shù)中的應(yīng)用[J];中國(guó)醫(yī)療設(shè)備;2013年03期

6 張劍寧;程崗;王亞明;劉銳;王洪偉;李志超;于新;趙全軍;趙虎林;章翔;;顱內(nèi)海綿狀血管瘤的外科治療[J];中華神經(jīng)外科雜志;2012年10期

7 王j;王佳;賀世明;秦懷洲;趙繼培;段云友;高國(guó)棟;;術(shù)中超聲定位在切除皮層下小病變中的應(yīng)用[J];中華神經(jīng)外科雜志;2011年10期

8 張巖;林松;趙繼宗;趙元立;王碩;姜中立;張懋植;王科大;;神經(jīng)導(dǎo)航結(jié)合術(shù)中超聲在顱內(nèi)海綿狀血管畸形切除術(shù)中的應(yīng)用研究[J];中華外科雜志;2011年08期

9 謝紅雯;王大明;袁慶國(guó);沙成;楊玉明;姜宏志;;神經(jīng)導(dǎo)航在顱內(nèi)海綿狀血管畸形顯微手術(shù)中的應(yīng)用[J];中華外科雜志;2011年08期

10 賈文清;林松;郭志祥;王立淑;何文;;術(shù)中超聲引導(dǎo)切除212例腦膠質(zhì)瘤[J];中華神經(jīng)外科雜志;2010年09期

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