摘要
目的 :评价应用神经外科导航系统指导显微切除颅内微小占位病变的手术效果和精确性 .方法 :应用StealthStation神经外科导航系统指导显微切除颅内微小占位病变2 6 (男 1 9,女 7)例 ,平均年龄 4 6 .6岁 .其中脑脓肿 9例 ,脑囊虫 7例 ,脑膜瘤 6例和炎性肉芽肿 4例 .病灶直径 8～ 30mm .对其手术效果、注册准确性、术中准确性进行分析 .结果 :手术全切率 1 0 0 % ,死亡率 0 .2 1例患者术后临床症状改善 ,5例无变化 ,无手术并发症 .平均坐标误差 (MFE) ,1 0cm预期准确性 (PA)分别为 (2 .6 3± 0 .93)mm和 (2 .4 6± 0 .82 )mm .持续准确性 1 (SA1 ) ,持续准确性 2 (SA2 )和持续准确性 3(SA3)依此为 (2 .36± 0 .75 )mm ,(1 .33± 0 .78)mm和 (1 .4 5± 1 .0 2 )mm ,术中SA2和SA3准确性相近 (P >0 .0 5 ) ,术中脑移位(1 .5 2± 0 .4 3)mm ,在允许范围内 .结论 :神经外科导航系统指导显微切除颅内微小占位病变定位准确可靠 ,且术中实时导航 ,有助于顺利寻找和全切病灶 。
AIM: To evaluate the operation result and accuracy of the microsurgery of intracranial minute lesions under the guidance of neuronavigation system. METHODS: StealthStation neuronavigation system was used to direct the microsurgical removal of 26 cases with intracranial minute lesions,including 19 men and 7 women, with an average age of 46.6. Nine of the 26 patients had brain abscesses, 7 cerebral cycticercosises, 6 meningiomas and 4 inflammatory granulomas. Lesion diameter was 8-30 mm. Operation result, fiducial accuracy and intraoperative accuracy were analyzed. RESULTS: Rate of total resection was 100% and death rate was 0. Clinical manifestations were improved in 21 cases, unchanged in 5 cases after operation, but there was no postoperative complication. MFE (mean fiducial error) and PA (predicted accuracy at 10 cm) were (2.63±0.93) mm and (2.46±0.82) mm. SA1 (sustained accuracy1), SA2 (sustained accuracy2) and SA3 (sustained accuracy3) were (2.36±0.75) mm, (1.33± 0.78) mm and (1.45±1.02) mm respectively. There was no obvious difference between the metrical values of intraoperative SA2 and SA3 ( P >0.05), and the intraoperative brain shift was (1.52±0.43) mm, within the permissive range. CONCLUSION: The neuronavigation system, presenting the real time localization, is accurate and reliable in the microsurgery of intracranial minute lesions and is helpful for the total removal of lesions and the decrease of postoperative complications.
出处
《第四军医大学学报》
CAS
北大核心
2003年第15期1408-1410,共3页
Journal of the Fourth Military Medical University
