摘要
目的总结采用新型接触式Ｎｄ∶ＹＡＧ激光进行颅内肿瘤切除的临床效果。方法２８例患者中脑膜瘤１４例、星形细胞瘤５例、听神经瘤４例、颅咽管瘤和髓母细胞瘤各２例、室管膜瘤１例。Ｓｔｏｒｚ内镜下激光手术３例，显微镜下激光手术４例，直视下激光手术２１例。接触式Ｎｄ∶ＹＡＧ激光波长１０６４μｍ，输出功率０～１００Ｗ。瘤周分离用尖探头，激光功率５～１５Ｗ；瘤内汽化用圆探头，激光功率一般３０～６０Ｗ，脑室内２０～４０Ｗ。结果除１例中颅凹底脑膜瘤、１例蝶骨嵴脑膜瘤和１例丘脑星形细胞瘤作次全切除外，其余均行肿瘤全切除，肿瘤手术全切率为８９％。术中输血２００～１２００ｍｌ（中位数为６００ｍｌ）。无手术死亡病例。术后２例出现轻偏瘫，１例出现轻面瘫，１例低热，占１４％。结论接触式Ｎｄ∶ＹＡＧ激光用于颅内肿瘤，尤其是脑深部和重要功能区肿瘤的切除，可提高切除率，减少手术死亡率和后遗症，值得临床推广。
Objective To summarize the therapeutic effects of contact Nd∶YAG laser in resection of brain tumors. Methods Among 28 cases of different brain tumors operated, there were 14 meningiomas, 5 astrocytomas, 4 acoustic neuromas, 2 meduloblastomas, 2 craniopharyngiomas and 1 ependymoma. 21 patients underwent common craniotomy. 3, laser endoscopy and 4, laser microsurgery. The contact Nd∶YAG laser light beam was 1.064 μm of wavelength and output of 0-100 W. The scalpel (GRP) was used to cut and seperate the gliomas from the surounding brain tissue at power of 5-15 W. The ventricular tumors were removed at power of 20-40 W. Round probe (MTRL) was used to vaporize parenchyma(at a power of 30-60 W) to a honeycomb like appearance and sucked away. Results All the tumors in this group were totally removed except one on sphenoid ridge, one in middle skull base and one in thalamus. The rate of total resection of tumors reached 89%. No patient died. 4 patients had mild complications: 1 fever, 2 hemiparalysis and 1 slight facial palsy. The average amount of blood loss for each patient was 600 ml or so (between 200-1 200 ml). Conclusions As an aspect of minimal invasive neurosurgery, contact Nd∶YAG laser has much more merits to traditional non contact Nd∶YAG laser or CO 2 laser. Operation by this modality may make bleeding reduced markedly, tumor resection become more thorough, and postoperative response, complications and mortality decreased obviously. This technique is especially suitable for resection of deeply seated brain tumors and deserves recommandation if possible.
出处
《中国激光医学杂志》
CAS
CSCD
1999年第1期27-29,共3页
Chinese Journal of Laser Medicine & Surgery
