摘要
目的 探讨内镜颅底外科手术危险因素预警系统在颅底脊索瘤手术中的应用价值.方法 应用内镜颅底外科手术危险因素预警系统（包括神经导航系统、电生理监测设备、经鼻术中超声系统和多普勒超声血管探测仪）辅助内镜下经鼻腔切除颅底脊索瘤48例,用于术中重要血管、神经、脑组织损伤和肿瘤残留等危险因素的识别和预警.结果 内镜颅底外科手术危险因素预警系统术中识别和保护颅底大动脉16例,脑神经5例,脑干2例,指导残余肿瘤切除4例.肿瘤全切11例（23％）,次全切25例（52％）,部分切除12例（25％）,无手术死亡病例,45例患者经1.0～1.5年随访,术后复发2例.结论 内镜颅底外科手术危险因素预警系统有利于病变及重要血管、组织的识别、定位,有利于提高病变切除率,保证手术安全性.
Objective To discuss the value and significance of risk factors early warning system of endoscopic skull base surgery （RFEWS） in the trans-nasal skull base chordoma surgery.Methods RFEWS was comprised of neuronavigation,intra-operative neurophysiologic monitoring equipments,intra-operative ultrasound and Doppler probe.The application of RFEWS in 48 chordoma patients who received endoscopic trans-nasal surgery was analyzed.RFEWS was used to recognize the intra -operation risk factors consisting of the crucial blood vessels or nerves damage and tumor residual.Results RFEWScould recognize and protect skull base main arteries in 16 cases,cranial nerves in 5,brain stems in 2 and guide residual tumor resection in 4.The total,subtotal and partial resection were performed in 11,25 and 12 patient respectively.After a follow-up of 48 patients for 12-18 months,2 patients were recurrent,there was no other severe complication.Conclusion Using RFEWS in skull base chordoma surgery was in favor of recognizing and locating important vessels and tissues and was helpful to raise the operation safety and excision rates.
出处
《中华神经外科杂志》
CSCD
北大核心
2014年第12期1189-1192,共4页
Chinese Journal of Neurosurgery
基金
卫生公益性行业科研专项基金资助（200902004）
