术中实时超声在颅内病变切除术中的运用

发布时间：2018-10-08 14:40

【摘要】：背景:随着科学技术近几十年的迅猛发展,神经外科也随之发展,手术逐渐由原来的传统开颅手术朝着向显微手术发展,手术方案更加精细化,个体化。为了达到以最小的损伤将病损切除,并能保护患者安全和神经功能。精准定位已成为手术成功与否的关键。在术中CT,术中MRI尚未普及的情况下,术中实时超声对颅内病变的定位与监测具有重要作用。目的:本实验通过对40例颅内病变患者在手术中实行术中超声实时监测与定位和对患者术后超早期进行康复治疗,总结患者术后的恢复情况。评估与评价术中实时超声对颅内病变定位与监测的运用价值。方法:选取2013年11月份至2015年9月份近两年来,在安徽医科大学第一附属医院神经外科门诊就诊并住院治疗的40例颅内病变患者,通过搜集并分析患者术前影像学,术中超声图片,术后病理,术后并发症和术后对患者早期心理疏通,早期康复等治疗后的相关随访资料,评价术中实时超声对颅内病变定位与监测的运用价值。结果:40例颅内病变患者在经过术中实时超声实时定位与监测下切除颅内病变,术中实时超声均能准确定位病变,了解病变性质与周围解剖情况;术后未见再出血,颅内感染,明显水肿与梗死等并发症,患者术前出现的偏瘫及失语等症状在术中实时超声监测下切除病变后有不同程度的好转,40例患者丧失的神经功能得到迅速恢复或一定程度的改善,从而提高了患者的生存质量,具有重大的社会价值。结论:术中实时超声定位精确,使用简便安全,在颅内病变切除中具有监测病变与重要血管神经等重要作用,降低患者出现严重并发症的概率,提高患者术后的生存质量,具有重大的社会价值,在术中CT,术中MRI尚未普及的情况下,值得推广。
[Abstract]:Background: with the rapid development of science and technology in recent decades, neurosurgery has also developed. Surgery has gradually moved from traditional craniotomy to microsurgery, and the operation plan is more refined and individualized. In order to minimize the injury to remove the lesion, and to protect the patient's safety and neurological function. Accurate positioning has become the key to the success of the operation. The intraoperative real-time ultrasound plays an important role in the localization and monitoring of intracranial lesions when MRI is not widely used in intraoperative CT,. Objective: to summarize the postoperative recovery of 40 patients with intracranial lesions by real-time monitoring and localization of intraoperative ultrasound and rehabilitation therapy in the early stage after operation. To evaluate the value of intraoperative real-time ultrasound in the localization and monitoring of intracranial lesions. Methods: from November 2013 to September 2015, 40 patients with intracranial lesions who were admitted to the Department of Neurosurgery, the first affiliated Hospital of Anhui Medical University, were collected and analyzed. In order to evaluate the value of intraoperative real-time ultrasound in the localization and monitoring of intracranial lesions, ultrasound images during operation, postoperative pathology, postoperative complications, early psychological dredging and early rehabilitation of patients were evaluated. Results 40 cases of intracranial lesions were resected by real-time ultrasonic localization and monitoring during operation. Real-time ultrasound could accurately locate the lesions, understand the nature of the lesions and the surrounding anatomy, and there was no rebleeding and intracranial infection after operation. The symptoms of hemiplegia and aphasia before operation were improved in different degree after real-time ultrasound monitoring. The neurological function of 40 patients was recovered quickly or improved to a certain extent. Thus, the quality of life of patients is improved and has great social value. Conclusion: the intraoperative real-time ultrasound localization is accurate, the use is simple and safe, it has the important function of monitoring the pathological changes and important vessels and nerves in the excision of intracranial lesions, so as to reduce the probability of serious complications and improve the quality of life of the patients after operation. It has great social value and is worth popularizing when MRI is not popularized in intraoperative CT,.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R651.1

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