摘要
目的 探讨StealthStation神经导航系统在颅脑手术中的应用。方法 观察 70例颅脑手术中应用StealthStation神经导航系统的情况 ,包括测量注册准确性 ,参考头架的不同使用方法对导航准确性的影响 ,检测术中准确性及不同部位病灶的术中脑移位 ,并对导航在不同肿瘤手术中的作用进行分析。结果 平均注册误差和 10cm预期准确性分别为 ( 2 5 6± 1 0 0 )mm和 ( 2 45± 0 78)mm。有 5例因平均注册误差 >4mm加用表面注册 ,结果误差减至 ( 1 0 9± 0 2 4)mm。除了微血管减压术 1例和活检 3例 (术后均症状改善或不变 )外 ,其余 66例病人共 67个病灶 ,全切除 5 5个 ( 82 9% )、次全切除 6个( 9 0 % )、大部切除 6例 ( 9 0 % )。术中持续准确性SA1、SA2和SA3分别为 ( 2 3 8± 1 2 7)mm ,( 1 2 1± 0 98)mm和 ( 1 3 5±1 13 )mm。症状改善或不变 5 8例 ( 87 9% )、加重 6例 ( 9 1% )、死亡 2例 ( 3 0 % )。结论 StealthStation神经导航系统在颅脑手术中提供术中动态跟踪、实时导航 ,准确可靠 ,有助于病灶全切除及降低手术并发症的发生。
Objective To elucidate the application of the StealthStation neuronavigation in neurosurgical operations. Methods A retrospective analysis of 70 patients with different intracranial lesions surgically treated with StealthStation system in Huashan hospital was conducted. To measure the mean fiducial error, the neuronavigational accuracy with the different patterns in usage of the reference arc, the sustained accuracy, and intraoperative brain shift are discussed. A preliminary analysis of intraoperative brain shift was performed in 26 cases with different locations of lesions. Results Mean fiducial error (MFE) and predicted accuracy at 10 cm (PA) were 2 56±1 00 mm and 2 45±0 78 mm, respectively SurfaceMerge registration was used to improve the registration accuracy in 5 patients because their MFE were greater than 4 mm and less than 5 mm. Except in 1 case of trigeminal neuralgia, biopsise were done in 3 cases, and neuronavigation guided lesionectomy in 66 cases(67 lesion, multiple cavernous angiomas in 1 case) were performed. Total lesion removal was achieved in 55 cases, subtotal removal in 6 cases. Among 66 cases with lesionectomies, postoperatively the neurological functions were improved or unchanged in 58 cases, worsen in 6 cases. 2 patients died of postoperative complications. Sustained accuracy including SA 1(K wire), SA 2(after craniotomy), and SA 3(after lesion removal) were 2 38±1 27 mm, 1 21±0 98 mm and 1 35±1 13 mm, respectively. Conclusions The StealthStation is reliable and accurate in crania cerebral neurosurgical procedures. It helps total removal of lesions and reduces postoperative complications.
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2000年第2期84-86,共3页
Chinese Journal of Nervous and Mental Diseases
