[1]卢锦江　张志浩　陈奥博　管江衡　丁慧超　宋　健　徐国政　马生辉.唤醒麻醉下皮层及皮层下电刺激联合神经导航辅助显微手术治疗岛叶胶质瘤[J].中国临床神经外科杂志,2021,26(04):229-232.[doi:10.13798/j.issn.1009-153X.2021.04.002]
　LU Jin-jiang,ZHANG Zhi-hao,CHEN Ao-bo,et al.Microsurgery assisted by cortical and subcortical stimulation under intraoperative awake anesthesia combined with neuro-navigation for patients with insular glioma[J].,2021,26(04):229-232.[doi:10.13798/j.issn.1009-153X.2021.04.002]
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唤醒麻醉下皮层及皮层下电刺激联合神经导航辅助显微手术治疗岛叶胶质瘤()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
26
期数:
2021年04期
页码:
229-232
栏目:
论著
出版日期:
2021-04-25

文章信息/Info

Title:
Microsurgery assisted by cortical and subcortical stimulation under intraoperative awake anesthesia combined with neuro-navigation for patients with insular glioma
文章编号:
1009-153X（2021）04-0229-04
作者:
卢锦江　张志浩　陈奥博　管江衡　丁慧超　宋　健　徐国政　马生辉
510515 广州，南方医科大学第一临床医学院（卢锦江、张志浩、陈奥博）；430070 武汉，中国人民解放军中部战区总医院神经外科（宋　健、徐国政、管江衡、丁慧超）；430065 武汉，武汉科技大学医学院（马生辉）
Author(s):
LU Jin-jiang1;  ZHANG Zhi-hao1;  CHEN Ao-bo1;  Guang Jiang-heng2;  DING Hui-chao2;  SONG Jian2;  XU Guo-zheng2;  Ma Sheng-hui3.
1. The First Clinical Medical College of Southern Medical University, Guangzhou 510515, China; 2. Department of Neurosurgery, General Hospital of Central Theater Command, Wuhan 430070, China; 3. Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
关键词:
岛叶胶质瘤; 显微手术; 唤醒麻醉; 神经导航; 皮层电刺激
Keywords:
Insular glioma;  Neuro-navigation;  Microsurgery;  Cortical and subcortical stimulation;  Awake anesthesia
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2021.04.002
文献标志码:
A
摘要:
目的 探讨唤醒麻醉下皮层及皮层下电刺激联合神经导航辅助显微手术治疗累及岛叶胶质瘤的效果。方法 回顾性分析2016年5月至2020年6月唤醒麻醉下皮层及皮层下电刺激联合神经导航辅助显微手术治疗的7例岛叶胶质瘤的临床资料。结果 术中皮质下电刺激显示6例出现运动反应，7例肿瘤切除达到功能边界。术后复查MRI显示肿瘤全切除6例，次全切除1例。术后出现一过性肢体/语言障碍6例，随访3个月，肌力Ⅲ~Ⅵ级5例，Ⅱ级1例；所有病人言语功能均恢复正常。7例术后随访24个月；术后6个月GOS评分5分2例，4分2例，3分3例；改良Rankin量表评分0分2例，2分2例，3分3例，4分2例；术后12个月复发2例（其中1例死亡），术后18个月1例复发、死亡，另4例无复发、存活。结论 唤醒麻醉下皮层及皮层下电刺激联合神经导航技术有助于提高手术切除岛叶胶质瘤的安全性和肿瘤全切除率，能有效地保护肿瘤周围的重要神经结构，降低神经功能障碍发生率。
Abstract:
Objective To explore the effectiveness of microsurgery assisted by cortical and subcortical stimulation under intraoperative awake anesthesia combined with neuro-navigation for the patients with insular glioma. Methods A retrospective analysis was performed on the clinical data of 7 patients with insular glioma who underwent surgical resection assisted by cortical and subcortical stimulation under intraoperative awake anesthesia combined with neuro-navigation from May 2016 to June 2020. Results Intraoperative cortical and subcortical stimulation showed that 6 patients had motor response, and the tumor resection reaching the functional boundary was achieved in all the patients. Postoperative re-examination of MRI showed that the tumors were totally resected in 6 patients and subtotally in 1. Transient dysfunction of limb movement and language occurred in 6 patients after the operation; the muscle strength was recovered to grade Ⅲ~Ⅵ in 5 patient and grade Ⅱ in 1, and the dysfunction of language was recoved well in the 6 patients within 3 months. All the patients were followed up for 24 months. Six months after the operation, GOS score of 5 points was achieved in 2 patients, 4 in 2, and 3 in 3; modified Rankin scale score of 0 point was achieved in 2 patients, 2 in 2, 3 in 3, and 4 in 2. Tumor recurrence occurred in 3 patients of whom 2 died during the follow up. Conclusions The cortical and subcortical stimulation under intraoperative awake anesthesia combined with neuro-navigation can increase the rate and safety of total tumor resection for the patients with insular glioma, which can effectively protect the important nerve structures around the tumor and reduce the incidence of neurological dysfunction.

参考文献/References:

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备注/Memo

备注/Memo:
通讯作者：徐国政，E-amil：xu-gz@163.com 宋　健，E-mail：sn413314@126.com
更新日期/Last Update: 2021-04-25