Điều trị phẫu thuật u não trong trục dưới hướng dẫn của siêu âm tại bệnh viện đa khoa Xanh Pôn=Intraoperative ultrasound in intra-axial brain tumors resection at Saint Paul hospital

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Tác giả: Trung Kiên Dương, Mạnh Hùng Nguyễn, Việt Đức Nguyễn, Việt Hoàng Trần, Ngọc Anh Vũ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.66-73

Bộ sưu tập: Metadata

ID: 478116

Thêm vào giỏ

Đánh giá kết quả phẫu thuật lấy u não trong trục khi áp dụng hệ thống siêu âm hướng dẫn trong phẫu thuật. Đối tượng và phương pháp: Nghiên cứu mô tả tiến cứu trên bệnh nhân nhân được chẩn đoán là u não được phẫu thuật lấy u có sử dụng hệ thống siêu âm trong phẫu thuật để đánh giá tại Bệnh viện đa khoa Xanh Pôn từ 1/2021 đến tháng 8/2024. Kết quả: Nghiên cứu thực hiện trên 51 bệnh nhân. Tuổi trung bình của đối tượng là 54,4 ± 11,7 với 32 (62,7%) bệnh nhân nam và 19 (37,7%) bệnh nhân nữ. Có 45 (88,2%) khối u được phẫu thuật nằm ở vùng bán cầu, 6 (11,8%) khối u ở hố sau. Khối u đơn độc gặp ở 46 (90,2%) bệnh nhân. U nguyên phát gặp ở 30 (58,8%) bệnh nhân và 21 (41,2%) bệnh nhân có u di căn. Chảy máu trong u ở 4 (7,8%) bệnh nhân. Về kết quả phẫu thuật, 19 (37,3%) bệnh nhân lấy hết được tổn thương, 15 (29,4%) bệnh nhân lấy gần toàn bộ, 13 (25,5%) bệnh nhân lấy bán phần, 4 (7,8%) bệnh nhân chỉ sinh thiết u. Kết quả lâm sàng cải thiện hoặc không thay đổi ở 48 (94,1%) bệnh nhân, 3 (5,9%) bệnh nhân tình trạng xấu đi hoặc tử vong. Có 4 (7,8%) bệnh nhân có biến chứng sau mổ, trong đó 1 (2%) bệnh nhân cần dẫn lưu não thất ổ bụng sau mổ. Chỉ số Karnofsky trung bình trước mổ và sau mổ lần lượt là 60.4 ± 10.2 và 75.3 ± 15.4, sự khác biệt có ý nghĩa thống kê (p=0,0043). Kết luận: Điều trị phẫu thuật các khối u não trong trục dưới hướng dẫn của siêu âm trong phẫu thuật có độ chính xác cao, tăng khả năng phẫu thuật lấy hết tổn thương, có hiệu quả tốt về mặt lâm sàng và chức năng cho bệnh nhân.To evaluate the surgical treatment outcome for patients undergoing intraaxial brain tumor resection with intraoperative ultrasound. Materials and methods: Prospective descriptive study on patients diagnosed with brain tumors who underwent tumor resection using intraoperative ultrasound for evaluation at Saint Paul hospital from January 2021 to August 2024. Results: totally 51 patients were included in the study. Their mean age was 54.4 ± 11.7 years, with 32 (62.7%) males, and 19 (37.7%) females. Forty-five (88.2%) of the surgically removed tumors were in the hemisphere, and six (11.8%) tumors were in the posterior fossa. Solitary tumors were found in 46 (90.2%) patients. Primary tumors were found in 30 (58.8%) patients, and 21 (41.2%) patients had metastatic tumors. Bleeding in the tumor was found in 4 (7.8%) patients. Regarding the surgical outcomes, 19 (37.3%) patients had total resection, 15 (29.4%) patients had sub-total resection, 13 (25.5%) patients had partial resection, and 4 (7.8%) patients had only tumor biopsy. Clinical outcomes improved or remained unchanged in 48 (94.1%) patients while 3 (5.9%) patients deteriorated or died. Four (7.8%) patients had postoperative complications, of which 1 (2%) patient required postoperative ventriculoperitoneal shunt. The mean preoperative and postoperative Karnofsky scores were 60.4 ± 10.2 and 75.3 ± 15.4, respectively (p=0.0043). Conclusion: Surgical treatment of intra-axial brain tumors with intraoperative ultrasound appeared to have high accuracy, increase the possibility of total tumoral resection, and bring good clinical and functional effects for the patients.

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