荧光素钠辅助引导技术在脑恶性肿瘤扩大切除手术中的临床分析

目的探讨荧光素钠（FLS）辅助引导技术在颅内恶性肿瘤扩大切除手术中的意义及临床分析。方法回顾性分析2016年11月—2020年3月新疆维吾尔自治区人民医院神经外科收治的122例脑恶性肿瘤患者的临床资料。所有患者术中均使用Zeiss Pentero 900荧光显微镜下切除肿瘤，其中66例患者术中应用FLS，56例患者未使用FLS，术中根据肿瘤的荧光染色情况或者根据经验判断肿瘤边界进行肿瘤切除。通过术前与术后MRI对比评估患者肿瘤切除程度。结果FLS组患者术中无对比剂相关不良事件发生，FLS组患者的出血量和手术时间明显低于常规手术组（P值分别为0.017和0.009），FLS组患者的肿瘤完全切除率显著高于常规手术组（78.8% vs 48.2%，P=0.009），FLS组的肿瘤复发率显著低于常规手术组（12.1% vs 25.2%，P=0.012）。结论术中应用FLS可明显减少术中出血量，缩短手术时间，此外可提高肿瘤切除率，降低肿瘤复发率，其在神经外科肿瘤手术中应用前景广泛。

Objective To investigate the clinical significance of fluorescein sodium（FLS） assisted technique in guiding extended resection of intracranial malignant tumors. Methods The clinical data of 122 patients with intracranial malignant tumors admitted in the Department of Neurosurgery, the People’s Hospital of Xinjiang Uygur Autonomous Region from November 2016 to March 2020 were analyzed retrospectively. All patients underwent tumor resection under Zeiss pentero 900 fluorescence microscope, of which 66 patients were treated with FLS and 56 patients were not treated with FLS. During the operation, the tumor boundary was determined according to the fluorescence staining of the tumor or experience. The extent of tumor resection was evaluated by preoperative and postoperative magnetic resonance imaging(MRI). Results There were no FLS related adverse events in the FLS group. The amount of bleeding and operation time in the FLS group were significantly lower than those in the conventional operation group(P values were 0.017 and 0.009, respectively). The complete tumor resection rate in the FLS group was significantly higher than that in the conventional operation group(78.8% vs 48.2%, P=0.009）, the tumor recurrence rate in the FLS group was significantly lower than that in the non fluorescein group(12.1% vs 25.2%, P=0.012). Conclusions The intraoperative application of FLS can significantly reduce the amount of intraoperative bleeding and shorten the operating time. In addition, it can improve the tumor resection extent and reduce the tumor recurrence rate. It has a wide application prospect in neurosurgical tumor surgery.