以相对偏离度评估穿刺准确度对微创术治疗脑出血疗效的影响  

Evaluation of Puncture Accuracy in Minimally Invasive Surgery for Intracerebral Hemorrhage with Relative Error

作　　者：梁奇明[1] 许峰[1] 连立飞[1] 王刚[1] 张逸驰[1] 王芙蓉[1] 唐洲平[1] 朱遂强[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院神经内科,武汉430030

出　　处：《华中科技大学学报（医学版）》2015年第3期317-321,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：目的介绍一种评估微创术穿刺准确度的方法——相对偏离度,并评估穿刺准确度对血肿清除效果的影响。方法回顾性分析2012年8月~2014年1月应用徒手穿刺法实施微创术联合重组组织型纤溶酶原激活剂治疗自发性幕上脑出血患者的临床资料,利用相对偏离度评估穿刺准确度,并分析穿刺准确度与抽吸、液化引流及血肿清除效果间的关系。结果共纳入53例患者,平均年龄（53.0±12.2）岁,术前血肿量为（38.3±12.1）mL。相对偏离度平均为（0.54±0.27）,相关分析显示相对偏离度与血肿清除率呈负相关（r=-0.591,P〈0.01）。相对偏离度≤0.6可能是较理想的准确度,53例中达到该准确度的比例为58.4%。结论相对偏离度是一种简便易行的评估穿刺准确度的方法。有必要进一步提高徒手穿刺法的穿刺准确度,以增强血肿清除效果。Objective To introduce a method,relative error（RE）,for assessment of puncture accuracy in minimally invasive surgery,and examine the effect of puncture accury on hematoma evacuation.Methods Clinical data of 53 patients with spontaneous supratentorial intracerebral hemorrhage who were treated by minimally invasive surgery with freehand pass technique and recombinant tissue plasminogen activator（rt-PA）between August 2012 and January 2014 were retrospectively analyzed.The puncture accuracy was evaluated by using RE and the relationship between the puncture accuracy and suction,liquid drainage,or hematoma evacuation was analyzed.Results A total of 53 patients were included in the study,with an average age of（53.0±12.2）years.Mean blood loss before surgery was（38.3±12.1）mL,and mean RE was（0.54±0.27）.Correlation analysis showed that there was a negative association between RE and hemorrhage evacuation rate（r=-0.591,P〈0.01）.RE≤0.6was the ideal accuracy of catheter placement.But only 58.4% patients achieved the ideal catheter placement with freehand pass technique.Conclusion RE is a simple and feasible method for evaluation of puncture accuracy.It is necessary to improve the puncture accuracy of freehand pass technique and promote hematoma evacuation.

关 键 词：脑出血 微创术 穿刺准确度 相对偏离度 

分 类 号：R651.12[医药卫生—外科学]