斜向立体定向穿刺法与垂直立体定向穿刺法的对比研究  

Comparison of oblique stereotactic puncture and vertical stereotactic puncture

作　　者：石林[1] 杨岸超[2] 孟大伟[2] 刘焕光[2] 张颖[1] 张鑫[1] 张建国[2] 

机构地区：[1]北京市神经外科研究所,北京100050 [2]首都医科大学附属北京天坛医院神经外科

出　　处：《立体定向和功能性神经外科杂志》2012年第6期349-351,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：国家自然科学基金项目(编号:81200997)

摘　　要：目的通过对比斜向立体定向穿刺法与垂直立体定向穿刺法的准确性、安全性的差别,探讨斜向立体定向穿刺法替代垂直立体定向穿刺法的可能性。方法雄性SD大鼠12只,分别采用斜向(左,20°)及垂直(右)立体定向穿刺法穿刺丘脑前核。穿刺后10小时行7.0T头部核磁共振检查,对比两种方法上矢状窦破裂发生率、穿刺针道与丘脑前核长轴所成夹角大小以及穿刺最深点位于丘脑前核内比例的差别。所有统计结果采用均数±标准差表示,用SPSS19.0医学统计程序进行配对样本t检验,P<0.05有统计学差异,P<0.01有显著性差异。结果斜向立体定向穿刺未出现上矢状窦破裂,垂直立体定向穿刺有3例发生上矢状窦破裂出血(25.0%)。斜向穿刺针道与丘脑前核长轴夹角为10.1±2.1度,垂直穿刺针道与丘脑前核长轴夹角为29.7±3.0度,斜向穿刺针道与丘脑前核长轴重合度更高(P<0.01)。斜向穿刺最深点位于丘脑前核内比例为58.3%(7/12),垂直穿刺最深点位于丘脑前核内比例为66.7%(8/12),两者穿刺准确性无统计学差异(P>0.05)。结论斜向立体定向穿刺法在安全性上优于垂直立体定向穿刺法,且通过选择适当角度可使穿刺针道与核团长轴重合度更高,两者准确性没有区别,因此前者更适合于动物实验中进行立体定向穿刺。Objective To determine the distinction of the safety and the precision between oblique stereotactic puncture and vertical stereotactic puncture. Methods 12 male SD rats were performed oblique stereotactic puncture （left, 20 degrees） and vertical stereotactic puncture （right）, both targeting the anterior nuclei of the thalamus（ANT）. After a 10h period of observa- tion, a 7.0 T MR scanning of the brain was conducted. Results The rupture rate of the superior sagittal sinus was 25.0% on the vertical side, the oblique side being none. The angles between the needle passage and the axis of ANT were 10. lq-2. 1 degrees on the left and 29.7 4-3. 0 degrees on the right（P〈0. 01）. Although 58. 3% （7/12） of the punture targets were within the range of the ANT on the oblique side while on the vertical side the rate mounted to 66.7G （8/ 12）, the difference was not statistically significant （P〈0. 05）. Conclusion In terms of safety and the overlap ratio of the needle passage and the axis of nuclei, if a proper puncture angel is chosen, the oblique puncture is superior to the classical vertical puncture. However, the accuracy between the two methods is not significantly disparate. Therefore in some cases the oblique punc- ture is better than the vertical one in animal experiments.

关 键 词：斜向立体定向穿刺 垂直立体定向穿刺 动物实验 

分 类 号：R651[医药卫生—外科学]