| Objective:In order to protect the functional areaglioma patients in the surgical removal of the maximum level, the smallest neurological damage and prevent the associated complications, intraoperative MRI IMRS aid of a surgical team, in a probe microscope microscopic navigation combined with the team’s self-imposed glioma resection original graph paper positioning assist probe navigation method. Investigate the effects of using graph paper positioning aid probe navigation glioma resection extent, operation time and prognosis, and evaluate the feasibility and effectiveness in clinical application. By using graph paper intraoperative MRI probe navigation and probe positioning aid navigation(intermittent navigation) application results in a comparative study of glioma patients in surgery, improving operating room nurse with surgical precision. MethodThe method of convenience sampling, select December 2013- November 2014, the First Affiliated Hospital of Zhengzhou University Surgical glioma patients treated 20 cases. Random number table met the inclusion criteria 20 patients were divided into two groups, divided graph paper positioning aid probe navigation group(experimental group) and probe the navigation group(control group), 10 patients in each group. The day of surgery, nurse installation headgear, assist the surgeon performed the day before surgery according to plan and draw navigation Register tumor surface projection, select the appropriate surgical approach incision.Coordinate paper positioning aid probe navigation group.(Experimental group): normal surgery after opening the Dura mater is exposed brain tissue, sterilization equipment nurses will coordinate paper cut to the right size, close to the cortical tissue, to assist doctors use the navigation probe search Relationship between tumor location and tumor boundary with the surrounding functional areas, doctor-assisted navigation probe dipped Meilan, graph paper to locate and record the extent of tumor, the surgeon in this range of tumor resection. When the tumor to the maximum range, Nurse removal of surgical instruments and non-magnetic-compatible instrument to 5G line, the patient with a sterile towel wrapped by the image GP surgery re MRI scan confirmed that MRI image display if necessary Continue surgical resection of residual tumor, update the navigation data again. Equipment nurses will close after sterilization of another suitable graph paper cut size of brain tissue, to assist doctors use the navigation probe dipped Mirren recorded on graph paper residual tumor localization and to determine the boundaries of the tumor and surrounding anatomy residual functional structure relations, the implementation of residual tumor resection within this range, after surgery the doctor again underwent magnetic resonance imaging MRI scan to determine the target removal effect. The end of surgery, surgical removal of the case to judge. Record the day of surgery in patients undergoing resection rate, time-consuming operation, after a week in January, June, respectively, to assess the quality of life of patients.Probe navigation group(control group): This group of patients according to intraoperative MRI images show the probe is still used for patients navigation mode surgery, other treatment measures consistent with graph paper positioning aid probe navigation group. Result1. The experimental group was 3.9 ± 4.1cm3 residual tumor volume was significantly lower than the control group, 10.3 ± 6.3cm3; the difference was statistically significant(P = 0.016). Experimental tumor resection rate was 95.2%, significantly higher than 85.6%, the difference was statistically significant(P = 0.006).2. The time-consuming operation in the experimental group(4.0 ± 0.8) h was significantly lower than the control group(5.1 ± 1.3) h, the difference was statistically significant(P = 0.035).3. The experimental group after one-week language AQ index score was 92.9 in the control group was 88.7-week average AQ index. One week after the experimental group was significantly higher language scores(P = 0.002). The experimental group in January- June Language AQ index averaged 91.9 score in the control group in January to June AQ index average 89.2. The experimental group in January- June Language score was significantly higher(P = 0.033).4.The experimental group after one week, after the January- June muscle strength grade was significantly higher, the difference was statistically significant(P <0.05).5. The experimental group from January to June KPS score 70 to 100 points, an average of 91.4 ± 4.5 points in the control group from January to June KPS score 60 to 100 points, an average of 86.5 ± 3.8 points. The experimental group in January-June KPS score was significantly higher(P = 0.018).6. The experimental group from January to June completeness tow significantly higher, the difference was statistically significant(P <0.05). ConclusionHigh field intraoperative MRI coordinate joint paper positioning aid probe navigation applies glioma resection, contribute to the maximum extent of glioma resection while preserving neurological structure, avoid leaving permanent neurological sequelae, thereby glioma prognosis and recovery have a positive impact on postoperative quality of life improved significantly. Coordinate paper using a probe positioning aid navigation, improved navigation and positioning surgery care with the technology to improve the operation efficiency. Coordinate the paper against the brain tissue, simple, not "brain shaft" effect. Use graph paper records intuitive navigation process so that the surgeon can more accurately and quickly identify important brain tumor boundaries and functional structure, so as to achieve a minimum level of skin damage and the greatest degree of excision surgery was significantly shorter time-consuming, improve operating room Precision with the ability to nurse. |
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