靶点穿刺法在幕上脑出血微创穿刺置管引流术中的应用研究  

Application of target puncture in minimally invasive puncture catheterization and drainage of supratentorial intracerebral hemorrhage

作　　者：戴志强 罗为 谢佳芯 李杰 张鑫 刘羽阳 帅康 杨凌 封亚平 Dai Zhiqiang;Luo Wei;Xie Jiaxin;Li Jie;Zhang Xin;Liu Yuyang;Shuai Kang;Yang Ling;Feng Yaping(Department of Neurosurgery,920th Hospital of Joint Logistics Support Forces,Kunming 650032,China;Department of radiology,The First Affiliated Hospital of Army Medical University,Chongqing 400038,China;Department of Neurosurgery,925th Hospital of Joint Logistics Support Forces,Guiyang 550009,China)

机构地区：[1]联勤保障部队第九二〇医院神经外科,昆明650032 [2]陆军军医大学第一附属医院放射科,重庆400038 [3]联勤保障部队第九二五医院神经外科,贵阳550009

出　　处：《中华神经外科疾病研究杂志》2024年第4期21-26,共6页Chinese Journal of Neurosurgical Disease Research

基　　金：国家重点基础研究发展计划(973计划,2014CB541600)。

摘　　要：目的探索靶点穿刺法在幕上脑出血微创穿刺置管引流术中穿刺的精准性和有效性。方法收集2020年1月1日至2024年5月31日在本研究作者所在医院接受微创穿刺治疗的患者,根据手术记录信息收集靶点穿刺法手术组患者52例和传统穿刺法手术组患者46例,评价穿刺准确性和血肿引流效果,通过格拉斯哥量表(Glasgow coma scale,GCS)、改良的脑出血分级量表(intracerebral hemorrhage grading scale,ICH-GS)、脑出血功能转归评分量表(intracerebral hemorrhage function outcome scale,ICH-FOS)评分评估临床效果及患者预后。结果靶点穿刺法手术组置管与血肿中心距离更短、残余血肿量更少、ICH-GS评分提高(P<0.05),GCS和ICH-FOS评分虽有改善,但无统计学意义(P>0.05)。结论靶点穿刺法定位精准,引流效果良好,简单易于掌握,适用于非标准颅脑CT扫描的血肿定位穿刺且没有专用定位工具的医院。Objective To explore the accuracy and effectiveness of target puncture in minimally invasive puncture catheterization and drainage of supratentorial intracerebral hemorrhage.Methods Cases of patients who received minimally invasive puncture treatment in the authors’hospital from January 1,2020 to May 31,2024 were studied.52 patients in the target puncture surgery group and 46 patients in the traditional puncture surgery group were divided according to the surgical records,and the accuracy of puncture and the effects of hematoma drainage were evaluated.The clinical effects and prognosis of patients were evaluated by GCS,ICH-GS and ICH-FOS scores.Results In the target puncture operation group,the distance between catheter placement and hematoma center was shorter,the amount of residual hematoma was lesser,and the ICH-GS score was increased(P<0.05).Although the GCS and ICH-FOS scores were improved,there was no statistical significance(P>0.05).Conclusion The target puncture is accurate and its drainage effect is good.As it is simple and easy to master,it is suitable for hospitals without special positioning tools for hematoma puncture localization in non-standard cranial CT scan.

关 键 词：脑出血 立体定位 微创穿刺 置管引流术 

分 类 号：R739.41[医药卫生—肿瘤]