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山东大学学报（医学版） ›› 2015, Vol. 53 ›› Issue (4): 80-82.doi: 10.6040/j.issn.1671-7554.0.2014.308

• 临床医学 • 上一篇    下一篇

电磁导航和术中B超辅助下功能区脑动静脉畸形显微外科治疗

李冰, 费昶, 郭锋, 孙爱刚, 郇林春, 郭守忠, 刘于海   

  1. 山东省临沂市人民医院神经外科, 山东 临沂 276003
  • 收稿日期:2014-05-12 修回日期:2014-12-31 出版日期:2015-04-10 发布日期:2015-04-10
  • 通讯作者: 李冰.E-mail:libingys@163.com E-mail:libingys@163.com

Microsurgical treatment of brain arteriovenous malformation in cerebral functional areas assisted with electro-magnetic navigation and ultrasound

LI Bing, FEI Chang, GUO Feng, SUN Aigang, HUAN Linchun, GUO Shouzhong, LIU Yuhai   

  1. Department of Neurosurgery, Linyi People's Hospital, Linyi 276003, Shandong, China
  • Received:2014-05-12 Revised:2014-12-31 Online:2015-04-10 Published:2015-04-10

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摘要： 目的 探讨电磁导航和术中B超在脑功能区脑动静脉畸形显微治疗中的作用.方法 分析2005年5月至2013年5月手术治疗的脑功能区血管畸形41例,其中2008年后使用电磁导航和术中B超辅助23例(辅助组),2008年前未使用18例(未辅助组),未辅助组直接行显微手术切除脑动静脉畸形.辅助组采用电磁导航、术中B超等技术确定脑动静脉畸形边界和脑功能区,根据脑动静脉畸形和功能区的关系切除脑动静脉畸形.结果 未辅助组畸形全切11例,次全切7例,术后功能良好10例,无变化2例,功能障碍加重6例,辅助组电磁导航系统定位成功率100%,图像匹配误差0.86~3.10 mm,平均1.52 mm,畸形全切21例,次全切2例,术后功能良好18例,无变化3例,功能障碍加重2例,两组畸形全切除率及术后功能障碍发生率差异有统计学意义(P< 0.05).结论 在电磁导航系统和术中B超的辅助下,可以做到精确的病灶解剖和脑功能定位,可提高脑血管畸形切除术手术精度,减少手术并发症.

关键词: 多发性骨髓瘤, 皮下注射, 脑动静脉畸形, 电磁导航, B超:显微外科手术, 硼替佐米, 原发性系统性淀粉样变

Abstract: Objective To explore the efficacy of electro-magnetic navigation and ultrasound in microsurgical treatment of brain arteriovenous malformation (AVM) in cerebral functional areas. Methods Clinical data of 41 cases of AVM treated in our hospital during May 2005 to May 2013 were retrospectively reviewed. The cases could be divided into 2 groups: the assisted group which received operation assisted with electro-magnetic navigation and ultrasound (n=23), and the non-assisted group which were treated solely with microsurgery (n=18). In the assisted group, after AVM and functional areas were located by electro-magnetic navigation and ultrasound, AVM was removed with reference to the relationship between AVM and functional areas. Results In non-assisted group, AVM was totally removed in 11 cases and subtotally removed in 7 cases. After operation, 10 cases recovered, 2 cases had no change, and 6 cases were impaired. In the assisted group, all intracranial lesions were accurately located. The matching error was 0.86-3.10 mm, mean 1.52 mm. The AVM was totally removed in 21 cases and subtotally removed in 2 cases. After operation, 18 cases recovered, 3 cases had no change, and 2 cases were impaired. The ratio of AVM resection in the assisted group was much higher than that in the non-assisted group. The ratio of dysfunction in the assisted group was much lower than that in the non-assisted group (P <0.05). Conclusion Assisted with electro-magnetic navigation and ultrasound, the AVM and functional area can be accurately located and complications can be substantially reduced.

Key words: Arteriovenous malformations, Ultrasound, Neuronavigation, Microsurgery

中图分类号: 

  • R651
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