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find Keyword "术前评估" 40 results
  • Stereotactic EEG-based cortical electrical stimulation in the preoperative evaluation of epilepsy

    Epilepsy is one of the most common neurological disorders, and surgical intervention is usually used for drug-resistant focal epilepsy. Cortical electrical stimulation is widely used in preoperative evaluation of epilepsy to explore the anatomical-clinical electrical correlations between epileptogenic and functional networks through electrical stimulation, and the functional brain maps produced by cortical electrical stimulation depict areas of the functional cortex at an individual level, identifying the functional cortex with greater precision, as well as helping to establish epilepsy network, enabling more precise localization of seizure zones and providing a more accurate localization for surgical resection. Electrical cortical stimulation has become a standard technique for the preoperative assessment of brain region function in brain surgery. It is an indispensable part of preoperative evaluation.The main types of functional mapping by electrical stimulation include stereoelectroencephalography (SEEG) and subdural electrode (SDE), SEEG-guided cortical electrical stimulation is gradually becoming more mainstream compared to subdural electrodes, and is increasingly valuable and important as a preoperative evaluation of epilepsy. It is increasingly demonstrating its value and importance because it avoids craniotomy, takes less time for surgery, has fewer associated complications and infections, and can explore deep lesions, increasing the understanding of human functional neuroanatomy and enabling more precise localization of seizure zones.This article reviews the history of the development of cortical electrical stimulation technology, the intrinsic mechanisms, the value of the application of SEEG, and also provides a comprehensive comparison between SEEG and SDE, despite the irreplaceable advantages of SEEG, attention should be paid to the unresolved clinical and scientific issues of SEEG, and the establishment of a consensus-based clinical guideline, as the application of this technology will be more widely used in both clinical and scientific work.

    Release date:2025-07-22 10:02 Export PDF Favorites Scan
  • 贲门癌术前肿瘤切除可能性的评估

    目的探讨贲门癌尤其是晚期贲门癌的临床特点,术前较正确的估计肿瘤手术切除的可能性,减少不必要的探查手术。方法根据肿瘤是否能被切除,将427例贲门癌患者分为两组,手术切除组:377例,贲门癌完全被切除;手术探查组:50例,均行开胸探查术。两组患者术前均未行化疗、放疗和介入等治疗,对两组患者术前的各项临床资料行单因索和logistic多因素分析。结果logistic多因素分析结果显示当肿瘤有明显的外侵、临床表现有明显的呕吐、上胸背疼痛或腹痛、消化道X线钡餐片表现为胃底广泛增厚、胃小弯肿瘤浸润明显或有巨大软组织阴影、肿瘤〉7cm者手术切除率低。分化程度较低的腺癌手术切除率亦低。结论肿瘤外侵、呕吐和疼痛症状、消化道X线钡餐造影表现、肿瘤的大小及病理类型对贲门癌患者术前肿瘤可切除性的评估有意义。

    Release date:2016-08-30 06:26 Export PDF Favorites Scan
  • 2023美国癫痫学会年会荟萃报道(三)

    美国癫痫学会(American Epilepsy Society,AES)年会是每年一度国际癫痫学界及工业界最受关注的会议。本年度的AES年会自2023年12月1日在奥兰多召开,为期5天,讨论了目前最受关注的癫痫学术领域及重点突破。本系列文章将分为五期,分别对大会每日的精彩内容进行荟萃报道:本文对大会第三日学术议程的内容进行了整理汇总,重点内容包括癫痫诊断及治疗的合理时机和最佳方案甄选,以及发育性癫痫性脑病、癫痫持续状态、基因性癫痫、术前评估、神经影像等热点话题。

    Release date:2024-03-07 01:49 Export PDF Favorites Scan
  • PET-CT 和 PET-MRI 在药物难治性癫痫中的研究进展

    手术是药物难治性癫痫的主要治疗手段,手术成功的关键在于术前对致痫灶的精确定位。近年来神经影像技术迅速发展,在难治性癫痫患者术前评估及疗效评价中发挥着重要的作用。本文对 PET-CT 和 PET-MRI 在药物难治性癫痫患者术前评估、预后判断以及 PET 脑受体显像剂等方面作一综述。

    Release date:2021-06-24 01:24 Export PDF Favorites Scan
  • Evaluation of 3D printing technology before transcatheter aortic valve replacement surgery

    Aortic valve disease is one of the major diseases threatening human health. Transcatheter aortic valve replacement (TAVR) is a new treatment for aortic disease. Preoperative evaluation is of great significance to the successful operation and the long-term quality of life of patients. The 3D printing technology can fully simulate the cardiac anatomy of patients, create personalized molds for patients, improve surgical efficiency, reduce surgical time and surgical trauma, and thus achieve better surgical results. In this review, the relevant literatures were searched, and the evaluation effect of 3D printing technology on the operation of TAVR was reviewed, so as to provide clinical reference.

    Release date:2022-03-18 02:44 Export PDF Favorites Scan
  • Randomized Controlled Trial of Combining MultiSlice Spiral Computer Tomography with Serum Amyloid A Protein or Fibrinogen on Rectal Cancer Surgical Decision Making

    Objective To determine the influence and significance of combinative assessment of 64 multi-slice spiral computer tomography (MSCT) with serum amyloid A protein (SAA) or fibrinogen (FIB) on the selection of operative procedures of rectal cancer under the multidisciplinary team. Methods Prospectively enrolled 240 patients diagnosed definitely as rectal cancer at West China Hospital of Sichuan University from February to June 2009 were randomly assigned into two groups. In one group named MSCT+SAA group, both MSCT and SAA combinative assessment were made for the preoperative evaluation. In another group named MSCT+FIB group, both MSCT and FIB combinative assessment were made for preoperative evaluation. Furthermore, the preoperative staging and predicted operation procedures were compared with postoperative pathologic staging and practical operation procedures, respectively, and the relationship between the choice of operation procedures and clinicopathologic factors was analyzed. Results According to the criteria, 234 patients were actually included into MSCT+SAA group (n=118) and MSCT+FIB group (n=116). The baseline characteristics of two groups were statistically similar (Pgt;0.05). For MSCT+SAA group, the accuracies of preoperative staging T, N, M and TNM were 72.9%, 83.1%, 100% and 80.1%, respectively. For MSCT+FIB group, the accuracies of preoperative staging T, N, M and TNM were 68.1%, 75.0%, 100% and 74.1%, respectively, and there was not a statistically significant difference (Pgt;0.05). There was also not a statistically significant difference of the accuracy of prediction to operative procedures in two groups (99.6% vs. 96.6%, Pgt;0.05). The preoperative T staging (P<0.001), N staging (P<0.001), TNM staging (P<0.001), serum level of SAA (P<0.001), serum level of FIB (Plt;0.001) and distance of tumor to the dentate line (P<0.05) were associated to the operative procedures. Conclusions Combinative assessment of MSCT and FIB could improve the accuracy of preoperative staging and operative procedures prediction, however, it may be not superior to MSCT plus SAA.

    Release date:2016-09-08 11:05 Export PDF Favorites Scan
  • Update on Preoperative Staging Strategies in Rectal Cancer

    Objective To summarize recent advances on preoperative staging strategies in rectal cancer. Methods Relevant references about preoperative staging strategies were collected and reviewed. The multimodal preoperative evaluation (MPE) system recently documented was focused on. Results The comparably accurate T and M stage could be achieved preoperatively by following an appropriate available method; however, the N stage’s accuracy was still not satisfying. The MPE system, incorporating with the advantages of transrectal ultrasound, computerized tomography and serum amyloid A protein in a multi-disciplinary mode could display the most accurate preoperative staging for rectal cancer currently. Conclusion The MPE has potential prospects in preoperative staging of rectal cancer, and can provide the most accurate preoperative staging for rectal cancer at present.

    Release date:2016-09-08 11:05 Export PDF Favorites Scan
  • 神经心理评估在癫痫术前评估中的应用

    神经心理评估,包括 Wada 试验和 eSAM 试验,长期应用于癫痫术前评估,且起着不可替代的作用,神经心理评估有助于协助临床上致痫灶的定位、预测癫痫手术后的效果以及指导手术后认知康复训练的时机。文章将从神经心理评估的定义、目的及作用、方法及内容、局限和展望等方面进行阐述,并介绍 Wada 试验,旨在加深对神经心理的评估,了解及规范 Wada 检查在癫痫术前评估中的应用。

    Release date:2019-07-15 02:48 Export PDF Favorites Scan
  • Role of preoperative assessment factors for decision-making on treatment modalities in papillary thyroid microcarcinoma with intermediate- and high-risk

    ObjectiveTo explore the role of preoperative evaluation indicators for decision-making on treatment modalities in papillary thyroid microcarcinoma (PTMC) with intermediate- and high-risk. MethodThe recent pertinent literatures on studies of risk factors influencing PTMC were collected and reviewed. ResultsThe surgical treatment was advocated for the PTMC with intermediate- and high-risk. However, the intraoperative surgical resection range and the postoperative prognosis of patients were debated. The malignancy of cell puncture pathology was a key factor in determining the surgical protocol. The patients with less than 45 years old at surgery, male, higher body mass index, higher serum thyrotropin level, and multifocal and isthmic tumors, and nodule internal hypoecho, calcification, unclear boundary, and irregular morphology by ultrasound, as well as mutations in BRAFV600E and telomerase reverse transcriptase gene were the risk factors for preoperative evaluation of PTMC with intermediate- and high-risk. ConclusionsAccording to a comprehensive understanding of preoperative risk factors for PTMC with intermediate- and high-risk, it is convenient to conduct an accurate preoperative evaluation and fully grasp the patients’ conditions. Clinicians should formulate individualized surgical treatment plans for patients based on preoperative assessment and their own clinical experiences.

    Release date:2023-06-26 03:58 Export PDF Favorites Scan
  • The effect of medication withdraw on long-term electroencephalogram monitoring in children who need preoperative assessment for refractory epilepsy

    PurposeTo analyze the effect of medication withdraw (MW) on long-term electroencephalogram (EEG) monitoring in children who need preoperative assessment for refractory epilepsy.MethodsRetrospective analysis was performed on the data of preoperative long-term EEG monitoring of children with refractory epilepsy who needed preoperative evaluation in the Pediatric Epilepsy Center of Peking University First Hospital from August 2018 to December 2019. Monitoring duration: at least three habitual seizures were detected, or the monitoring duration were as long as 10 days. MW protocol was according to the established plan.ResultsA total of 576 children (median age 4.4 years) required presurgical ictal EEGs, and 75 (75/576, 13.0%) needed MW for ictal EEGs. Among the 75 cases, 38 were male and 37 were female. The age range was from 15 months to 17 years (median age: 7.0 years). EEG and clinical data of with 65 children who strictly obey the MW protocol were analyzed. The total monitoring duration range was from 44.1 h (about 2 days) to 241.8 h (about 10 days)(median: 118.9 h (about 5 days)). Interictal EEG features before MW were including focal interictal epileptiform discharge (IED) in 39 cases (39/65, 60%), focal and generalized IED in 2 cases (2/65, 3.1%), multifocal IED in 20 cases (20/65, 30.7%), multifocal and generalized IED in 2 cases (2/65, 3.1%), and no IED in 2 cases (2/65, 3.1%). After MW, 18 cases (18/65, 27.7%) had no change in IED and the other 47 cases had changes of IED after MW. And IEDs in 46 cases (46/65, 70.8%) were aggravated, and IED was decreased in 1 case. The pattern of aggravated IED was original IED increasement, in 41 cases (41/46, 89.1%), and 5 cases (5 /46, 10.9%) had generalized IED which was not detected before MW. Of the 46 patients with IED exacerbations, 87.3% appeared within 3 days after MW. Habitual seizures were detected in 56 cases (86.2%, 56/65) after MW, and within 3 days of MW in 80.4% cases. Eight patients (14.3%) had secondary bilateral-tonic seizure (BTCS), of which only 1 patient had no BTCS in his habitual seizures. In 56 cases, 94.6% (53/56) had seizures after MW of two kinds of AEDs.Conclusions① In this group, thirteen percent children with intractable epilepsy needed MW to obtain ictal EEG; ② Most of them (86.2%) could obtain ictal EEG by MW. The IED and ictal EEG after MW were still helpful for localization of epileptogenic zone; ③ Most of the patients can obtain ictal EEG within 3 days after MW or after MW of two kinds of AEDs;4. The new secondary generalization was extremely rare.

    Release date:2021-04-25 09:50 Export PDF Favorites Scan
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