无创头架结合改良穿刺探针在高血压性基底节区脑出血中的应用  

Application of noninvasive neurosurgical head frame combined with modified puncture probe in hypertensive basal ganglia cerebral hemorrhage

作　　者：茹德文 王尔松 姚慧斌 费力 刘猛 颜玉峰 RU De-wen;WANG Er-song;YAO Hui-bin;FEI Li;LIU Meng;YAN Yu-feng(Department of Neurosurgery,Jinshan Hospital,Fudan University,Shanghai 201508,China)

机构地区：[1]复旦大学附属金山医院神经外科,上海201508

出　　处：《复旦学报（医学版）》2022年第3期435-440,共6页Fudan University Journal of Medical Sciences

基　　金：上海市卫计委面上项目(201740180)。

摘　　要：目的探讨无创头架结合改良穿刺探针在高血压性基底节区脑出血手术中的应用价值。方法选取2017年1月至2020年12月复旦大学附属金山医院符合纳入标准和排除标准的高血压性基底节区脑出血患者76例,随机分成无创头架组和有创头架组,进行神经导航辅助脑内血肿微创穿刺置管引流。其中,无创头架组使用改良穿刺探针。比较两组患者手术时间、导航注册误差、住院周期、肺部感染率及术后6个月神经功能恢复情况。结果两组患者在年龄、性别、入院收缩压、入院时血肿量和入院格拉斯哥昏迷评分(Glasgow Coma Scale,GCS)等基线数据差异无统计学意义,术后6个月神经功能恢复亦无统计学差异。然而,在手术时长、导航注册误差、住院时长、肺部感染率等方面无创头架组均优于有创头架组,差异有显著统计学意义(P<0.01)。结论无创头架结合改良穿刺探针在神经导航辅助脑内血肿微创穿刺置管治疗高血压性基底节区脑出血手术中具有注册误差小、手术时间短、操作简单精准、住院周期短、并发症少等优势。Objective To investigate the application value of noninvasive head frame combined with modified puncture probe in the operation of hypertensive basal ganglia cerebral hemorrhage.Methods A total of 76 patients with hypertensive basal ganglia intracerebral hemorrhage who met the inclusion and exclusion criteria from Jinshan Hospital,Fudan University from Jan 2017 to Dec 2020 were randomly divided into the non-invasive head frame group and the invasive head frame group for neuronavigationassisted minimally invasive puncture drainage of intracerebral hematoma.Modified puncture probe was used in non-invasive head frame group.The operation time,navigation registration error,hospitalization period,pulmonary infection and neurological function recovery at 6 months after surgery were compared between the two groups.Results There was no significant difference in baseline data such as age,gender,admission systolic blood pressure,admission hematoma volume and GCS score at admission between the two groups,and there was no significant difference in neurological function recovery 6 months after surgery.However,the non-invasive head frame group was superior to the invasive head frame group in operation time,navigation registration error,hospitalization period,pulmonary infection and other aspects,and the difference was statistically significant(P<0.01).Conclusion In the treatment of hypertensive basal ganglia intracerebral hemorrhage with neuronavigation-assisted minimally invasive catheterization of intracerebral hematoma,the non-invasive head frame combined with modified puncture probe has the advantages of small registration error,short operation time,simple and accurate operation,short hospitalization period,and fewer complications.

关 键 词：无创头架 改良穿刺探针 基底节区脑出血 神经导航 

分 类 号：R651.1[医药卫生—外科学]