Chen Xi, Sun Jinli, Jiang Weichao, Zhu Zhi, Chen Sifang, Tan Guowei, Wang Zhanxiang
Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361003, China.
Department of Reproduction, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361003, China.
Brain Res Bull. 2022 Apr;181:30-35. doi: 10.1016/j.brainresbull.2021.12.017. Epub 2022 Jan 4.
To discuss the techniques and methods in respective operation of brain gliomas located in eloquent brain region under awake anesthesia state METHODS: 21 patients admitted into Department of Neurosurgery of the First Affiliated Hospital of Xiamen University were chosen as subject. Diagnosed with brain gliomas, they received operation with neuronavigation, intraoperative ultrasonography for locating the lesion and intraoperative direct electric stimulation for functional mapping of the eloquent brain region after receiving awake anesthesia. All patients were followed up from post-surgical 3 months to 18 months.
Applied with MRI scanning during post-surgical 60-90d, resection results shows that 5 cases (23.8%) received total resection of lesions, 10 cases (47.6%) received subtotal resection while 6 cases (28.6%) received partial resection. Post-surgical performance shows 8 cases (38.1%) of transitory postoperative aphasia, 5 cases(23.8%) of transitory postoperative dyskinesia and 1 case(4.8%) of permanent dyskinesia. Recovery was achieved in the patients except for the 1 case of permanent dyskinesia.
Comprehensive application of awake anesthesia, neuronavigation, intraoperative ultrasonography and intraoperative direct electrical stimulation facilitates recognition of clear position relationship between gliomas and eloquent brain region, and maximum safe resection of gliomas in eloquent brain region with maximal protection of brain function.
探讨清醒麻醉状态下位于脑功能区的脑胶质瘤各自手术中的技术和方法。方法：选取厦门大学附属第一医院神经外科收治的21例患者为研究对象。他们被诊断为脑胶质瘤，在接受清醒麻醉后，采用神经导航、术中超声定位病变以及术中直接电刺激对脑功能区进行功能定位，然后进行手术。所有患者术后随访3个月至18个月。
术后60 - 90天进行MRI扫描，切除结果显示，5例（23.8%）病变全切，10例（47.6%）次全切，6例（28.6%）部分切除。术后表现为8例（38.1%）出现短暂性术后失语，5例（23.8%）出现短暂性术后运动障碍，1例（4.8%）出现永久性运动障碍。除1例永久性运动障碍患者外，其余患者均康复。
清醒麻醉、神经导航、术中超声及术中直接电刺激的综合应用有助于明确胶质瘤与脑功能区的位置关系，最大程度安全切除脑功能区胶质瘤并最大程度保护脑功能。
