侧脑室额角穿刺角度的公式推导及验证

Derivation and validation of the formula for the puncture angle of frontal horn of the lateral ventricle

目的探讨侧脑室额角的最佳穿刺角度。方法将71例脑出血后发生急性非交通性脑积水病人,随机分为观察组(n=35)和对照组(n=36)。对照组采用传统方法经额角行侧脑室外引流术,观察组在确定侧脑室额角目标穿刺点的基础上,精确测量后计算穿刺角度,然后据此行侧脑室额角穿刺术并放置引流。比较两组穿刺次数和置管位置。结果对照组共放置引流管39根,观察组放置37根。两组的穿刺次数和置管位置比较有统计学差异(P<0.05)。与对照组比较,观察组明显减少穿刺次数并取得更为理想的置管位置。结论因个体差异,应根据每例病人颅脑CT结果进行测量并计算得出合适的穿刺角度后再行额角穿刺,可最大限度避免穿刺失败或置管位置不佳。

Objective To explore the optimal puncture angle of the frontal horn of the lateral ventricle. Methods Seventy-one patients with acute obstructive hydrocephalus secondary to intracerebral hemorrhage were randomly divided into observation group（n = 35） and control group（n = 36）. A traditional method was adopted for external ventricular drainage via the frontal horn in patients in observation group. Based on the selection of puncture site, the puncture angle was calculated after accurate measurement, and then the puncture and drainage at the frontal horn of the lateral ventricle were performed in observation group. Puncture frequency and position of drainage tube in the lateral ventricle were compared between two groups. Results There were 39 drainage tubes in control group and 37 in observation group. There were statistical differences in both puncture frequency and position of drainage tube in the lateral ventricle between two groups（P〈0.05）. The puncture frequency was less and position of drainage tube was better in observation group than in the control group. Conclusions In puncture at the frontal horn of the lateral ventricle, the operation should be performed according to the proper puncture angle which should be measured and calculated based on intracranial CT of every patient because of individual differences. The method can avoid the puncture failure and bad position of drainage tube to the greatest degree.