O臂导航引导下的立体脑电图深部电极置入

O-arm navigation guided under the stereo-electroencephalography deep electrode placement

目的探讨O臂导航在立体脑电图深部电极置入中的应用。方法收集25例在O臂导航引导下置入深部电极的癫痫患者,观察深部电极置入的精度和并发症,与单独使用神经导航方法和有框架立体定向方法比较。结果 O臂导航组25例患者置入深部电极数目在7~16根,共计254根。置入平均误差在1.36±0.44mm,优于导航组和立体定向组。电极置入平均耗时,O臂导航组17.2分钟,导航组19.4分钟,明显低于立体定向组的34.5分钟。电极置入的平均数,O臂导航组10.2根,导航组4.8根,立体定向组2.2根。O臂导航组无血肿、感染、脑脊液漏,导航组1例血肿,并发症发生率低于立体定向组。结论神经导航是构建立体脑电图的较佳工具,特别是需要置入较多电极时,具有方便、并发症少等优点,O臂导航联合应用可以提高电极置入的精确度。

Objective To explore the application of O--arm navigation in deep electrode implantation of stereo--electroencephalography（SEEG）. Methods 25 patients with epilepsy un- der the guidance of O--arm navigation were enrolled. The accuracy and complication of deep elec- trode implantation were observed, compared with the frameless neuronavigation and the frame stereotactic groups. Results In O--arm navigation group,a total of 254 electrodes were implanted into 25 patients,average 7~16 electrodes. The average implantation error was 1.36 ~ 0.44 mm, which is superior to the frameless neuronavigation and the frame stereotactic groups. In the O-- arm navigation group,an average of 17.2 min was required to implant each electrode, which was significantly shorter than the time required in frameless neuronavigation group （19.4 rain） and the frame stereotactic group （34. 5 rain）. The average number of implantations was 10. 2 elec- trodes/case in the O--arm navigation group, 4. 8 electrodes/case in the navigation group, and 2. 2 electrodes/case stereoscopic group. There was no hematoma,infection or cerebrospinal fluid leak- age in the O--arm navigation group. One patient in the navigation group suffered from hematoma. The overall complication rate in the O--arm navigation group was lower than that in the frame group. Conclusion Neural navigation is a better tool for electrode implantation in SEEG especial- ly when it is necessary to implant multiple electrodes, it is more convenience,less time consuming and causes less complications. The combination of O--arm navigation and Neural navigation will significantly improve implantation accuracy.