简易脑立体定向装置的研制及临床应用

Simplified Stereo orientation Apparatus for Brain Operation : Design and Application Study

【目的】自行研制简易脑立体定向装置并应用于临床。【方法】采用自制简易颅内三维定位仪及颅内穿刺定向仪,于操作前先计算CT,MR 病灶在自制三维定位仪的位置,然后标记在头皮上对应的部位,算出穿刺病灶中心的深度及病灶在颅内三维方向的具体轮廓及其方位,再作颅内病灶的穿刺或开颅手术皮瓣设计。【结果】①模拟病灶(10 m m ×10 m m ×10 m m) 定位精度平均误差X 轴1 .2 m m ;Y 轴1 .3m m ;Z轴1 .2 m m ;②经模拟试验后应用于神经外科临床共217 例,其中颅内穿刺93 例,指导开颅手术皮瓣设计124 例。颅内穿刺病灶一次命中率100 % 。开颅手术皮瓣设计切口与病灶部位无一偏移。【结论】该立体定向装置定位准确,能满足幕上立体定向手术需要,能有效保护脑功能,符合微侵袭手术原则。其结构简单,使用方便,造价低廉,适用于各级医院尤其在基层医院。

Objective To investigatethe clinicalefficiency of asimple stereotactic apparatus used for brain operation . Methods Focuslocations in 217 patients were analyzed by CTor magneticresonanceimaging ( MRI) scan.Then ,according to the data collected from the home made stereotactic apparatus,the projections ofthese focuslocations on their scalp were marked ,and the depth and width of these intracranial foci were calculated in three dimensional directions.Brain punctures were performed in 93 patients and 124 patients received craniotomy and flap design. Results ①On the mimiclocations,the average error of precision was 1 .2 m m on Xaxis,1 .3 m m on Y axis and 1 .2 m m on Zaxis;②The target accuracy in brain puncture was 100 % .In this research,thescalp designs wereconsistent with cerebralfocuslocations which were found during operations. Conclutions Thisstereotactic apparatusis precise and it can provide accurate orientations for supratentorial operations.With the help of apparatus brain parenchyma can be protected from damage to a great extent,fulfilling the principle of minimally invasive neurosurgery.Its construction in simple,application is convenient and the manufacturing cost is cheap .This apparatus can meet various requirementsfor many hospitals.