论文部分内容阅读
目的总结术中唤醒麻醉下,皮质电刺激(CS)联合皮质脑电图(ECoG)监测治疗功能区肿瘤继发癫癎的临床经验。方法回顾性分析功能区28例胶质瘤及13例脑膜瘤继发癫癎病人的临床资料,采用唤醒麻醉下开颅,通过CS定位感觉、运动及语言区,ECoG定位致癎区,显微手术切除肿瘤及处理致癎灶。结果术中CS定位功能区33例,阴性8例;ECoG发现致癎灶29例,无异常12例。胶质瘤全切21例,次全切7例;脑膜瘤全切12例,次全切1例。术后暂时性神经功能障碍加重或新发障碍25例,均于1个月内恢复。随访41例,时间6个月-5.5年。癫癎发作消失29例,明显减少12例。结论唤醒麻醉下联合CS、ECoG治疗功能区肿瘤继发性癫癎,能最大限度保护脑功能,安全处理致癎灶。
OBJECTIVE: To summarize the clinical experience of epilepsy in the treatment of functional tumor with functional epilepsy under intraoperative awake anesthesia and cortical electrical stimulation (CS) combined with ECoG monitoring. Methods The clinical data of 28 patients with gliomas and 13 patients with epilepsy secondary to meningioma in functional area were retrospectively analyzed. Craniotomy was performed under wakeful anesthesia, and the sensory, motor and language areas were located by CS. Surgical removal of the tumor and treatment caused by foci. Results CS was located in 33 cases of functional area, negative in 8 cases; ECoG found in 22 cases of foci, no abnormalities in 12 cases. Twenty-one cases of gliomas were excised, seven cases were subtotally resected, 12 cases of meningioma were excised, and one case of subtotal resection. Twenty-five patients with transient neurological dysfunction or new onset of disorder recovered within 1 month. Follow-up 41 cases, time 6 months - 5.5 years. Epileptic seizures disappeared in 29 cases, significantly reduced in 12 cases. Conclusion Arousal anesthesia combined with CS, ECoG treatment of functional tumor secondary to epilepsy, can maximize the protection of brain function, safe handling of foci.