摘要目的 通过对运动区胶质瘤患者实施术中唤醒配合中央沟定位胶质瘤切除术,初步探讨该技术对运动功能的保护作用.方法 对56例运动区附近胶质瘤患者进行喉罩插管、全麻下无头皮夹快速开颅、术中唤醒,通过皮质诱发电位进行中央沟定位,在保护脑功能的同时最大程度切除肿瘤,最后在唤醒状态或全麻下快速关颅.结果 所有患者均顺利完成手术,4例患者出现新发神经功能障碍,52例患者术后神经功能障碍无明显加重或改善.肿瘤全切除29例,次全切除20例,大部分切除7例.无出血、围手术期死亡等严重并发症,术后患者均无痛苦回忆.结论 唤醒状态配合神经电生理监测中央沟定位切除运动区胶质瘤,能够在保护患者脑功能的前提下最大程度地切除肿瘤,改善患者预后.

abstractsObjective To study the protective effects of intraoperative waken-up and central sulcus location on motor function for patients with gliomas locating in motor areas.Methods 56 patients with gliomas in motor areas were intubated with laryngeal mask,rapidly underwent craniotomy without scalp clips,waken-up,localized the central sulcus by somatosensory evoked potential.On the condition of protecting the brain function,the greatest degree of tumor resection was performed and then the close-skull under awake state or general anesthesia was finished.Results All the patients underwent operation successfully.Except for the emergence of new nervous dysfunction in four patients,most patients' neurological functions were not deteriorated or even had improved.Besides,there was no complication and postoperative painful memories for the patients.Conclusions Resection of gliomas in motor areas with intraoperative waken-up and localization of central sulcus could ensure the largest degree of tumor resection on the premise of protection of the brain function.As a result,it could improve the prognosis of the patients.