改良梯形定位法结合CT多平面重建在基底节区脑出血经额穿刺血肿定位的临床应用  

The clinical application of modified trapezoidal localization combined with CT multi-planner reconstruction in the localization of transfrontal puncture hematoma with cerebral hemorrhage in basal ganglia region

作　　者：蔡学坚 林晓燕 梁土焕 黄剑 何贵文 CAI Xuejian;LIN Xiaoyan;LIANG Tuhuan;HUANG Jian;HE Guiwen(Department of Neurosurgery,Dongguan Integrated Traditional Chinese and Western Medicine Hospital,Dongguan,Guangdong 523820,China;Department of General,Dongguan Integrated Traditional Chinese and Western Medicine Hospital,Dongguan,Guangdong 523820,China;Department of Radiology,Dongguan Integrated Traditional Chinese and Western Medicine Hospital,Dongguan,Guangdong 523820,China)

机构地区：[1]东莞市中西医结合医院神经外科,广东东莞523820 [2]东莞市中西医结合医院综合科,广东东莞523820 [3]东莞市中西医结合医院放射科,广东东莞523820

出　　处：《影像研究与医学应用》2022年第21期35-38,共4页Journal of Imaging Research and Medical Applications

基　　金：东莞市科技计划项目,项目名称《改良梯形定位法结合CTMPR重建在基底节区脑出血经额穿刺血肿定位的临床应用》(202050715042746)。

摘　　要：目的:探讨改良梯形定位法结合CT多平面重建(multi-planner reconstruction,MPR)对基底节区脑出血经额穿刺术在定位血肿穿刺靶点的准确性及可操作性的影响。方法:选取东莞市中西医结合医院2020年6月—2022年5月收治的高血压病基底节区脑出血患者50例,设为治疗组,行经额穿刺置管外引流术,采用改良梯形定位法结合CT多平面重建定位血肿穿刺靶点的位置;另选取原有行改良-立体定向软通道颅内血肿清除术的患者50例为对照组。比较两组在穿刺血肿靶点的准确率及手术时间,同时分析治疗组术前血肿穿刺靶点在冠状面头颅顶部体表投影定位点和正中矢状面垂直距离总体均数的95%可信区间。结果:治疗组穿刺血肿靶点的准确率为96.0%,高于对照组的84.0%,差异有统计学意义(P<0.05);治疗组手术时间为(27.32±3.13)min,短于对照组的(34.01±4.03)min,差异有统计学意义(P<0.05);治疗组术前血肿穿刺靶点在冠状面头颅顶部体表投影定位点和正中矢状面垂直距离总体均数的95%可信区间为(3.3,3.6)cm。结论:改良梯形定位法结合CT多平面重建为高血压病基底节区脑出血经额穿刺提供一种新的更有效的血肿穿刺靶点定位方法,使血肿穿刺靶点定位操作方法更简单直观,提高穿刺靶点准确率及手术效率。Objective To investigated the effect of the modified trapezoidal placement method and CT multi-planner reconstruction on the accuracy and operability of transfrontal puncture of cerebral hemorrhage in locating the hematoma puncture target in the basal ganglia.Methods A total of 50 patients with intracerebral hemorrhage in the basal ganglia region of hypertension who were admitted to Dongguan Integrated Traditional Chinese and Western Medicine Hospital from June 2020 to May 2022 were selected as the treatment group and underwent transfrontal puncture and external drainage,combined with the improved trapezoidal positioning method.CT multi-planner reconstruction locates the location of the hematoma puncture target;another 50 patients who underwent modified-stereotactic soft channel intracranial hematoma evacuation were selected as the control group.Results The accuracy of the puncture hematoma target in the treatment group was 96.0%,which was higher than 84.0%in the control group,and the difference was statistically significant(P<0.05);The operation time in the treatment group was(27.32±3.13)min,which was shorter than(34.01±4.03)min in the control group,the difference was statistically significant(P<0.05);The 95%confidence interval of the overall mean of the vertical distance between the median sagittal plane is(3.3,3.6)cm.Conclusion The modified trapezoidal positioning method combined with CT multi-planner reconstruction provides a new and more effective method for cerebral hemorrhage in the subregion of hypertension,which makes the operation method more simple and intuitive,and improves the accuracy and surgical efficiency.

关 键 词：改良梯形定位法 CT多平面重建 基底节区脑出血 改良-立体定向软通道颅内血肿清除术 

分 类 号：R445.3[医药卫生—影像医学与核医学]