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目的探讨直接电刺激在功能区神经上皮肿瘤手术中应用的意义。方法对44例大脑功能区神经上皮肿瘤手术中应用直接电刺激的临床资料进行回顾性总结。结果所有病例均在充分保护功能区的前提下,最大程度切除肿瘤,其中39例术中定位出运动区,14例定位出语言功能区;肿瘤全切28例,次全切12例,部分切除4例。平均随访23.5个月,无病生存35例(79.5%),死亡6例(13.6%)。15例术后出现短暂性一侧肢体活动障碍,11例出现短暂语言功能障碍,1例术后遗留永久性肢体运动功能障碍。所有患者均无痛苦回忆。结论皮层电刺激是一种可靠无创的脑功能区定位方法,在神经上皮肿瘤手术中应用此技术可在有效保护脑功能的前提下最大限度地切除功能区病变。
Objective To investigate the significance of direct electrical stimulation in functional neuroepithelial neoplasm surgery. Methods The clinical data of 44 patients with neuroepithelial neoplasm in brain functional area undergoing direct electrical stimulation were retrospectively reviewed. Results In all cases, the tumors were completely removed under the premise of fully protecting the functional areas. Among them, 39 cases were located in the motor area and 14 cases were localized in the speech function area. Tumor resection was performed in 28 cases and subtotal resections in 12 cases. Partial resection 4 cases. With an average follow-up of 23.5 months, 35 patients (79.5%) had disease-free survival and 6 patients died (13.6%). Fifteen patients had transient limb dysfunction after operation, 11 had transient language dysfunction, and 1 had permanent limb dysfunction after operation. All patients have no painful memories. Conclusion Cortical electrical stimulation is a reliable and noninvasive method for locating brain functional regions. The application of this technique in neuroepithelial neoplasms can effectively remove the functional area lesion under the premise of effectively protecting brain function.