术中B超实时监测在幕上病变精准手术中的临床应用

摘要

Objective To summarize experience with intraoperative real time type‐B ultrasound in precise delimitation of the supratentorial lesions . Methods Fifty intraoperative type‐B ultrasound studies were carried out in patients with supratentorial lesions(35 glioma ,8 cavernous hemangiomas ,3 meningio‐mas ,3 metastatic tumors and one aneurysm) . Results Intraoperative type‐B ultrasound could accurate‐ly localize the supratentorial lesions and assist in microsurgical resecting of the supratentorial lesions . Total resection in 30 glioma patients and subtotal resection in 5 . The precise delimitation of the other lesions including 8 cavernous hemangiomas ,3 meningiomas ,3 metastatic tumors and one aneurysm ,w hich assisted by intraoperative real time type‐B ultrasound ,were also successfully performed . There were no new postoperatively neurological deficits ,no operative complications ,no mortality and no intraoperative ultrasound‐related complications in these patients . Conclusions The intraoperative ultrasound is a very useful tool in intraoperative real time localization and delineation of lesions and planning various stages of supratentorial lesions resection . It assisted neurosurgeons in maximizing resections of supratentorial lesions and preserving the neurological function in a safe manner . It is an easy ,convenient ,reliable , widely available and cost‐effective tool .%目的：总结术中B超实时监测在幕上病变精准切除中临床应用经验。方法应用术中B超实时监测定位及辅助切除50例幕上病变，其中胶质瘤35例，海绵状血管瘤8例，脑膜瘤3例，转移瘤3例，动脉瘤1例。结果术中B超实时监测能清晰地显示病灶，准确定位并切除。35例胶质瘤中，全切除30例，次全切除5例；海绵状血管瘤8例、脑膜瘤3例以及转移瘤3例均成功进行准确定位和完整切除；大脑后动脉巨大动脉瘤行孤立术1例。术后神经功能保存良好，未出现明显并发症，无手术死亡，未出现术中B超相关并发症。结论术中B超实时监测是定位大脑病变、确定边界以及制定精准手术计划的一种非常有用的辅助工具，可辅助术者最大程度切除幕上病变和保留神经功能，具有易掌握、便捷、可靠、实时以及可广泛使用等特点。