CT三维重建矢状位矩形定位定向法在经额微创治疗基底节区血肿的应用

Application of rectangular location and orientation in sagittal plane of CT three-dimensional reconstruction in minimally invasive transfrontal puncture drainage for basal ganglia hemorrhage

目的探讨CT三维重建矢状位矩形定位定向法在经额微创治疗基底节区血肿的应用。方法对48例高血压性基底节区脑出血患者术前行CT薄层扫描,并三维重建,经额定位定向尺辅助,经额行锥颅定向穿刺置管血肿清除术。术后立即复查颅脑CT测量达靶点的误差,术后1个月的进行临床疗效评定。结果在经额定位定向尺的辅助下对48例患者行穿刺术,穿刺均达预设的靶点,平均误差为(4±1.2)mm;术后3 d血肿清除率达(80.2±14.6)%;术后无气颅及颅内感染。术后1个月基本痊愈10例,显著进步8例,进步23例,无效或恶化2例,死亡5例;总有效率85.4%。结论 CT三维重建矢状矩形位定位定向法是经额穿刺治疗基底节区血肿可靠的方法。

Objective To investigate the application of rectangular location and orientation in sagittal plane of CT three-dimensional reconstruction in minimally invasive transfrontal puncture drainage for basal ganglia hemorrhage. Methods Forty-eight patients with hypertensive basal ganglia hematoma received CT thin slice scan and made three-dimensional reconstruction imaging before operation. Then minimally invasive transfrontal puncture drainage was carried out by using the designed apparatus. CT scan was performed for assessment of puncture needle placement at postoperative immediate, and the clinical curative effect was judged at 1 mouth after operation. Results The minimally invasive transfrontal puncture drainage was carried out by using the designed apparatus in 48 patients. The puncture point reaches a preset target. The average error was （4 ±1. 23 ） ram. The ratio of hematoma remove was （80 2 ± 14.6） % in 3 d after puncture. No pneumocrania and intracranial infection were happend in this group There was basic clinical cures in 10 cases, marked improvement in 8 cases, improvement in 23 cases, invalid or exacerbation in 2 cases, and death in 5 cases. The total effective rate was 85.4%. Conclusion Rectangular location and orientation in sagittal plane of CT three-dimensional reconstruction is a reliable method for minimally invasive transfrontal puncture drainage for hyertensive basal ganglia hemorrhage.