颅内血肿微创清除术中穿刺路径立体定位标记线的优化设计研究  

Study on optimal design of three-dimensional puncture-line in the minimally invasive removal of intracranial hematoma

作　　者：吴海龙 胥亦龙 罗树芳 毛林花 祝金香 

机构地区：[1]江西玉山县中医院中风诊疗中心,玉山334700 [2]江西玉山县人民医院ICU,玉山334700

出　　处：《中国实用神经疾病杂志》2009年第3期7-9,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的研究颅内血肿微创清除术中穿刺路径立体定位标记线的画法,解决穿刺方向问题。方法根据三个平面相互垂直,那么它们的交线也相互垂直的基本原理,先在穿刺平面CT片上作穿刺路径OG的延长线和矢状位的正中线AP相交于E点,然后通过E点,作冠状位的直线FE垂直于AP;再在头表标出正中矢状面、冠状面和穿刺水平面的立体定位标志线。通过正中矢状面和冠状面在头表的交点B,标出穿刺路径在头表的标记线OB,它和穿刺水平面的标记线OF共同构成穿刺路径的立体标记线,引导穿刺方向。结果2005-01～2008-08我们采用该方法共实行穿刺23例,其中小脑1例,丘脑3例,基底节15例,脑叶2例,脑室2例,一次穿刺成功率达100%,偏差<0.5cm。结论在头颅表面设计穿刺路径立体定位标记线的方法,解决了穿刺方向的定位难题,填补了前人在该领域的研究空白。它设计科学合理,操作简单,不添加任何辅助设备,只做了方法学上的优化,符合视觉生理,能完全满足各种角度穿刺的要求,成功率高,值得临床推广。Objective To introduce a puncture-tag-line painting method of the minimally invasive removal of intracranial hematoma in the way of the three-dimensional positioning, which solutes the puncture direction difficulty. Methods According to the principle that three planes are mutually perpendicular, their intersections also keep mutually perpendicular. Make the extension of the OG puncture line in the puncture plane of CT-film, and intersect midline sagittal AP at point E, then cross point E, make coronal straight line AP in a perpendicular to the FE; OB and OF forms the puncture way of three-dimensional tag line, guiding the direction of puncture. Results From January 2005 to August 2008, we had adopted the method of implementation of a total of 23 cases of aspiration, of which 1 case in cerebellum, 3 cases in thalamus, 15 cases in basal ganglia, 2 cases in lobe, 2 cases in ventricle, a successful puncture was 100%, the deviation was less than 0. 5cm Conclusion The design of puncture-tag-line painting of three-dimensional positioning in the surface of the skull is efficient, and solutes the puncture direction difficulty, fills the blank in the field of research. It is scientific and a rational design, simple operation, not adding any auxiliary equipment, just only a methodological optimization, in line with visual need. It is able to fully meet the various requirements of the puncture point of view; the success rate is high and it is worth to be popularized.

关 键 词：穿刺路径 穿刺方向 立体定位 标记线 优化设计 

分 类 号：R651.11[医药卫生—外科学]