[1]林涛,陈志杰,刘妲,等.机器人辅助立体定向活检术在脑深部病变中的应用[J].中国临床神经外科杂志,2023,28(06):378-382.[doi:10.13798/j.issn.1009-153X.2023.06.008]
　LIN Tao,CHEN Zhi-jie,LIU Da,et al.Application of robot-assisted stereotactic biopsy in deep brain lesions[J].,2023,28(06):378-382.[doi:10.13798/j.issn.1009-153X.2023.06.008]
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机器人辅助立体定向活检术在脑深部病变中的应用()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
28
期数:
2023年06期
页码:
378-382
栏目:
论著
出版日期:
2023-06-30

文章信息/Info

Title:
Application of robot-assisted stereotactic biopsy in deep brain lesions
文章编号:
1009-153X（2023）06-0378-05
作者:
林涛; 陈志杰; 刘妲; 邓斌; 山常国; 王辉; 郭强; 陈俊喜; 李海南; 蔡林波
510510广州，广东三九脑科医院肿瘤神经外科（林涛、陈志杰、刘妲、邓斌），肿瘤综合治疗科（山常国、王辉、蔡林波），癫痫外科（郭强、陈俊喜），病理科（李海南）
Author(s):
LIN Tao1;  CHEN Zhi-jie1;  LIU Da1;  DENG Bin1;  SHAN Chang-guo2;  WANG Hui2;  GUO Qiang3;  CHEN Jun-xi3;  LI Hai-nan4;  CAI Lin-bo2
1. Department of Tumor Neurosurgery,Guangdong 999 Brain Hospital,Medical College of Jinan University,Guangzhou 510510,China; 2. Department of Integrative Tumor Therapy,Guangdong 999 Brain Hospital,Medical College of Jinan University,Guangzhou 510510,China
关键词:
脑深部病变; 立体定向活检术; 机器人; 应用价值
Keywords:
Deep brain lesions;  Stereotactic biopsy;  Robots;  Application value
分类号:
A
DOI:
10.13798/j.issn.1009-153X.2023.06.008
文献标志码:
R 737.41; R 651.1+1
摘要:
目的 探讨机器人辅助立体定向活检术在脑深部病变中的应用价值。方法 2015年6月至2021年5月实施机器人辅助脑内深部病变活检术38例，对病人的临床资料进行回顾性分析。结果 38例行41个靶点活检（3例行双靶点活检）。7例首次穿刺术中冰冻切片病理检查结果为阴性，其中6例通过调整穿刺点再次穿刺为阳性，1例术后常规病理为阳性。所有病人均得到确诊，确诊率为100%。38例术后病理结果显示胶质瘤 24例（WHO分级Ⅰ~Ⅱ级4例，Ⅲ~Ⅳ级 20例），淋巴瘤9例，生殖细胞瘤4例，淀粉样变性1例。术后发现术区血肿6例，包括5例无症状性小出血和1例严重迟发性脑出血导致死亡。结论 神经外科机器人引导下脑深部病变活检术具有精准、微创、阳性率高的特点，选择合适的病人并掌握神经外科机器人的使用方法，结合术前影像确定靶点、术中冰冻切片病理检查等方法是提高脑深部病变立体定向活检术确诊率并减少相关并发症的关键。
Abstract:
Objective To investigate the application value of robot-assisted stereotactic biopsy in deep brain lesions. Methods Robot-assisted biopsy was performed on 38 patients with deep brain lesions from June 2015 to May 2021, and the clinical data of the patients were retrospectively analyzed. Results Thorty-eight patients underwent 41 target biopsies (3 patients underwent double target biopsies). The negative results of the first intraoperative frozen section examination (IFSE) occurred in 7 patients, of whom 6 patients got positive results after re-puncture by adjusting the puncture point, and 1 got positive on postoperative pathological examination. All the patients got positive results and the positive rate was 100%. The pathological results of 38 patients showed glioma in 24 patients (4 WHO grade Ⅰ~Ⅱ, 20 WHO grade Ⅲ~Ⅳ), lymphoma in 9, germinal cell tumor in 4 and amyloidosis in 1. Postoperative hematoma occurred in 6 patients, including 5 asymptomatic light hemorrhage and 1 severe delayed cerebral hemorrhage resulting in death. Conclusions Neurosurgical robot-guided biopsy of deep brain lesions is accurate, minimally invasive and has a high positive rate. Selecting suitable patients and mastering the use of neurosurgical robots, identifying targets in combination with preoperative imaging and IFSE are the keys to improve the positive rate of stereotactic biopsy of deep brain lesions and reduce related complications.

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备注/Memo

备注/Memo:
（2022-02-18收稿，2023-04-12修回）
基金项目：广东省医学科学技术研究基金（B2023418）
通讯作者：蔡林波，E-mail：cailinbo999@163.com
更新日期/Last Update: 2022-06-30