颅脑创伤患者侧脑室穿刺置管精准度的相关影响因素分析

Factors associated with accuracy of external ventricular drain placement in patients with traumatic brain injury

目的探讨影响颅脑创伤患者侧脑室穿刺置管精准度的相关因素。方法回顾性分析111例颅脑创伤患者,经侧脑室穿刺置管术后行CT薄层扫描,通过Logistic回归分析影响置管精准度的相关因素。结果穿刺置管位置良好并能通畅引流脑脊液79例,置管成功率为71.17%,穿刺置管精准度与医生手术操作因素有明显相关性,而与患者性别、年龄、术前GCS评分、脑外伤诊断类型、术前是否中线移位及穿刺点位置(左/右侧)等无统计学意义。结论医生手术操作是影响置管成功率的关键因素,提高手术操作精度还可通过设备辅助来提高置管成功率。

Objective To investigate the factors associated with the accuracy of external ventricular drain placement in patients with traumatic brain injury （TBI）.Methods The clinical data and computed tomography （CT） findings of 111 patients with TBI,who had undergone external ventricular drain placement and thin-slice CT scans,were retrospectively reviewed.The factors that affected the accuracy of external ventricular drain placement were identified by logistic regression analysis.Results A total of 79 patients achieved tube patency and smooth cerebrospinal fluid flow,and the success rate of external ventricular drain placement was 71.17%.The main factors that affected the accuracy of external ventricular drain placement were the surgical experience of neurosurgeons.The sex,age,preoperative Glasgow Coma Scale score,type of TBI,midline shift before operation,and puncture point （left or right side） did not seem to affect the accuracy.Conclusions The accuracy of external ventricular drain placement is associated with the surgical experience of neurosurgeons,so we still need to improve the success rate of external ventricular drain placement through navigation techniques.