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目的评价神经导航辅助与传统显微外科手术切除脑膜瘤的临床疗效。方法将96例位于大脑凸面、窦旁及镰旁的脑膜瘤患者随机分为导航组50例,传统组46例。导航组在神经导航系统辅助下制定手术计划并通过术中精确定位引导显微手术,传统组则通过术者经验、解剖标志等对肿瘤进行定位并切除。分析两组患者手术切口长度、骨瓣面积、术中出血量、术后1周KPS评分、肿瘤SimpsonⅠ级切除率等。结果 (1)在手术切口长度、骨瓣面积、术中出血量、手术时间及术后1周KPS评分方面导航组均优于传统组(P<0.05)。(2)肿瘤SimpsonⅠ级切除率:导航组33例(66.0%),传统组28例(60.9%),两组比较无统计学差异(P>0.05)。结论神经导航辅助下精确指导显微手术切除脑膜瘤,与传统显微手术相比,能够减少无效暴露的同时并不影响肿瘤的切除程度,实现了创伤最小化,并提高患者术后生活质量。
Objective To evaluate the clinical efficacy of neuronavigation assisted with conventional microsurgery for meningiomas. Methods A total of 96 patients with meningiomas located in the convex coronal, paravertebral and falx were randomly divided into the navigation group (50 cases) and the traditional group (46 cases). The navigation group developed a surgical plan with the aid of a neuro-navigation system and guided the microsurgical operation through intraoperative precise positioning. In the traditional group, the tumor was located and excised by experience of the surgeon and anatomical landmarks. The length of incision, bone flap area, intraoperative blood loss, KPS score at 1 week after operation, and Simpson Ⅰ resection rate were analyzed. Results (1) The navigation group was superior to the traditional group in the length of the incision, the area of the flap, the blood loss during operation, the operation time and the KPS score at 1 week after operation (P <0.05). (2) Simpson grade I resection rate: 33 cases (66.0%) in the navigation group and 28 cases (60.9%) in the traditional group. There was no significant difference between the two groups (P> 0.05). CONCLUSIONS: With the help of neuronavigation, micrometastasis of meningiomas is precisely guided. Compared with traditional microsurgery, it can reduce ineffective exposure without affecting tumor resection, minimize trauma, and improve postoperative quality of life.