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目的探讨语言功能区胶质瘤的手术策略。方法回顾性分析手术治疗30例语言功能区胶质瘤。在唤醒麻醉下应用术中直接皮质电刺激确定语言区,根据功能边界切除肿瘤。评价患者的功能结果及切除程度。结果术中语言功能区监测成功20例;未监测到4例;因麻醉或术中高颅压不能进行监测6例。随访3个月,3例患者存在中度语言功能障碍。全切14例,近全切12例,大部切除4例。结论术中皮质电刺激确定语言功能区准确、安全、可靠。唤醒麻醉下进行术中皮质电刺激结合术前神经功能影像技术,确定切除肿瘤的功能边界,能够最大程度切除肿瘤,同时保护正常的语言功能,使术后语言障碍的风险降到最低。
Objective To explore the surgical strategies of gliomas in language functional areas. Methods Retrospective analysis of surgical treatment of 30 cases of gliomas of lingual function. Under awakening anesthesia, intraoperative direct cortical electrical stimulation was used to determine the language area and tumors were excised based on functional boundaries. Evaluation of patient functional outcome and extent of resection. Results Twenty (20) cases were successfully monitored in the functional areas of the intraoperative language, 4 cases were not detected, and 6 cases could not be monitored due to anesthesia or intraoperative high intracranial pressure. Three months after follow-up, three patients had moderate language dysfunction. Full cut in 14 cases, nearly complete resection in 12 cases, most of the resection in 4 cases. Conclusion Intraoperative cortical electrical stimulation to determine the language function area is accurate, safe and reliable. Wake anesthesia under intraoperative cortical electrical stimulation combined with preoperative neurofunctional imaging technology to determine the removal of the tumor’s functional boundaries, to maximize the removal of the tumor, while protecting the normal language function, postoperative language risk to a minimum.