偏向穿刺法在经额角侧脑室穿刺中的应用研究

The study of the optimal puncture direction through the forehead angle of the ventricle

目的：探讨偏向穿刺法在侧脑室额角穿刺中应用的准确性。方法选取颅内出血合并急性脑积水患者50例，建立经额角侧脑室穿刺线的冠状位平面，取中线偏开2.5 cm为标准穿刺点位置。采用平行刺入法和偏向刺入法两种方法模拟脑室穿刺过程，引流管进入同侧脑室内为成功。结果偏向穿刺法50例全部成功，成功率为100.0%；平行穿刺法50例中，31例穿刺成功，成功率为62.0%，偏向穿刺法成功率显著高于平行穿刺法成功率（P＜0.001）。结论对于颅内出血继发脑积水患者，采用偏向穿刺法可以显著提高穿刺成功率。

Objective Explore accuracy of the optimal puncture direction through the forehead angle of the ventricle. Methods Firstly, select 50 cases of intracranial hemorrhage complicating acute hydrocephalus patients. Secondly, these coronal planes based on the forehead angle puncture way of ven？tricles were established on the CT images. And we choose the line which is 2.5 cm aside from midline of these reconstructed coronal planes as the normal puncture point. Thirdly, we adopted parallel Pierce method and bias Pierce method to simulate the puncture process. Finally, the mark of success is the ac？cess of drainage tubes into the ipsilateral lateral ventricle. Results All of the cases using the bias Pierce methods succeeded with the success rate of 100.0%. Only 31 cases were successful among the 50 cases by parallel Pierce method, and the success rate is 62.0%. The statistical analysis proved that there is much difference between these two methods（P〈0.001）, and the bias pierce method of the success rate is significantly higher than parallel ones. Conclusion The bias pierce method can obviously im？prove the success rate compared with the parallel methods for the patients with intracranial hemorrhage complicating acute hydrocephalus.