[摘要] 目的 探讨运用立体定向技术行锁孔手术切除颅内功能区小病灶的方法和疗效。方法 18例颅内功能区小病灶(直径1.5~3 cm), 使用Leksell-G 立体定向仪，在CT或MR导向下，采用小切口, 环钻开颅；在导针引导下，先行电生理刺激，沿非功能区皮层下斜形径路切除。结果 在Leksell-G定向系统精确定位和电生理刺激下，病灶全切率达100%。本组18例病理结果：脑膜瘤6例,转移瘤6例,炎性肉芽肿4例,海绵状血管瘤1例,胶质瘤1例。术后神经功能保护良好,无手术并发症及死亡。结论 立体定向引导下的锁孔显微手术切除功能区小病灶,是一种定位精确、微创、安全、有效的手术方法。

    [关键词] 立体定向；锁孔；微创；功能区小病灶

    Stereotactic guided “key-hole” microsurgical resection of small intracranial lesions in functional region

    XU Kan, CHEN Xin, WU Xin-chang, et al.Department of Neurosurgery, Putuo Hospital,Shanghai University of Traditional Chinese Medicine, Shanghai 200062,China

    [Abstract] Objective To investigate the operative method and therapeutic effect of stereotactic guided “key-hole” microsurgical resection of small intracranial lesions in functional region.Methods Eighteen patients with small intracranial lesions (with diameter varied between 1.5 and 3 cm) in functional region were involved in this series. MR (CT) guided stereotactic localization was performed with Leksell-G stereotactic system. A little incision was made and the skull was opened with an annular drill. Electrical physiological stimulation was made to get the operative approach avoiding functional region. Then the resection of lesions was executed by leading of guided needle which was fixed according to stereotactic localization. Results All lesions were dissected in total without mortality and neurological deficient. According to pathological examinations, 6 of 18 cases were with meningiomas, 6 with metastatic tumors, 4 with inflammatory granuloma, 1 with cavernous angioma, and 1 with glioma. Conclusion Stereotactic guided “key-hole” microsurgical resection of small intracranial lesions in functional region is an effective and safe operative method with accurate localization and micro invasion. ......