摘要
目的探讨MRI技术用于神经外科手术时对麻醉的影响。方法选取60例胶质瘤患者,随机分为两组,30例在术中磁共振成像(iMRI)及功能神经导航指导下行开颅胶质瘤切除(iMRI组),30例在功能神经导航指导下行传统开颅胶质瘤切除(N组),记录两组患者一般情况、麻醉时间、手术准备时间、手术时间、术中出血量、输液量、输血率、术前及术后血红蛋白浓度、术后体温、肌肉松弛剂用量、围术期与iMRI及麻醉相关的意外情况等。结果与N组比较,iMRI组患者一般情况、麻醉时间、术中出血量、输液量、输血率、血红蛋白浓度及术后体温均无显著差异(P>0.05),但手术准备时间、手术时间明显延长,肌松药用量明显增加(P<0.05)。两组均无与iMRI及麻醉相关的意外发生。结论 iMRI用于神经外科手术提高了手术精确度,使肿瘤切除更彻底,但手术时间明显延长,而其他围术期特点与传统神经外科手术并无差别。iMRI用于神经外科手术时的麻醉处理在遵循一般神经外科麻醉处理原则的基础上,还应关注长时间手术的麻醉调控。
Objective To observe the influcences of intraoperative magnetic resonance imaging（iMRI） used in neurosurgery on anesthesia.Methods Sixty patients with glioma were randomly divided into two groups（30 each）,the patients in iMRI group underwent craniotomy and glioma ablation under the guidance of iMRI and functional neuro-navigation,and in N group with the functional neuro-navigation only.The patients＇ general status and concerning parameters were observed and recorded,including anesthesia duration,preparation time for surgery,duration of surgery,blood loss,volume of fluid administration,number of patients who needed blood transfusion,preoperative and postoperative hemoglobin,postoperative body temperature,dosage of muscle relaxant,and the unforeseen incidents related to iMRI and anesthesia.Results No significant differences existed between the two groups（P0.05） in patients＇ general status,anesthesia duration,blood loss,volume of fluid administration,numbers of patients who needed blood transfusion,preoperative and postoperative hemoglobin,and body temperature.However,the preparation time for and duration of surgery were longer,the dosage of muscle relaxant was larger in iMRI group than in N group（P0.05）.No inadvertent incident related to iMRI and anesthesia occurred in both groups.Conclusions The application of iMRI in neurosurgery may improve the accuracy in operative manipulation and make the tumor resection more thorough,but it may prolong duration of surgery.Other perimoperative care related to iMRI surgery is similar to that of traditional functional neuro-navigation surgery.Besides the basic rules of neurosurgery anesthetic management for neurosurgery,anesthetist should focus on anesthetic adjustment for a long operation.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2011年第9期942-944,共3页
Medical Journal of Chinese People's Liberation Army
关键词
磁共振成像
麻醉
神经外科手术
magnetic resonance imaging
anesthesia
neurosurgical procedures
