【摘要】 目的探讨神经电生理监测在功能区胶质瘤术中的应用价值。方法对2012年1月至2014年12月术中行神经电生理监测的738例功能区胶质瘤的临床资料进行回顾性分析。结果 608例在全麻下行术中神经电生理监测,130例在唤醒麻醉下行运动和或语言功能定位。所有病例术后近期运动障碍发生率为11.7%,远期为3.8%;语言区胶质瘤术后近期的失语率为28.8%,远期为4.1%。术中MRI辅助下进行电生理监测347例,全切率为89.3%。全麻下3.6%的患者术中出现癫痫大发作;唤醒麻醉下2.3%的患者出现一侧肢体或嘴角抽搐,仅1例(0.8%)出现癫痫大发作。结论根据胶质瘤所在的部位选择适当的术中神经电生理监测技术,有助于最大程度切除肿瘤的同时,保护患者的功能皮层和皮层下重要功能通路,降低致残率,提高远期生活质量。更多还原

【Abstract】 Objective To explore the value of intraoperative neuroelectrophysiologic monitoring(IONM) to the surgery for gliomasin eloquent function brain regions.Method The clinical data of 738 patients with gliomas in eloquent function brain regions, whounderwent surgery under IONM from January, 2012 to December, 2014, were analyzed retrospectively.ResultsOf 738 patients, 608 underwent somatosensory evoked potential or motor evoked potential monitoring under general anesthesia and 130 did cortical andsubcortical motor mapping or awake language mapping. Eighty-six patients(11.7%) suffered from early motor deficit after the surgery.Late motor deficit was observed in 28 patients(3.8%). Twenty-one patients(28.8%, 21/73) had early speech deficit and late speechdeficit was only observed in 3 patients(4.1%, 3/73). The rate of gross total resection of the tumors was 89.3% in 738 patients.ConclusionsIONM can be applied safely and effectively to the resection of gliomas in the eloquent function brain regions because it ishelpful to the protection of the eloquent function cortexes and subcortical pathways and total resection of the tumors as possible in thepatients with gliomas in eloquent function brain regions.更多还原