经颅外标志侧脑室额角穿刺术在重型颅脑损伤患者的临床应用

The clinical application of the frontal puncture of lateral ventricle by extracranial marker in severe traumatic brain injury

目的探讨经颅外标志侧脑室额角穿刺术在重型颅脑损伤的临床应用。方法将神经外科重型颅脑损伤患者153例随机分为观察组(经颅外标志侧脑室额角穿刺,n=81)和对照组(常规侧脑室额角穿刺,n=72),对比两组穿刺成功率。结果观察组81例,穿刺成功76例,成功率93.83%;对照组72例,穿刺成功51例,成功率70.83%;观察组穿刺成功率明显高于对照组,差异具有统计学意义(χ2=14.287,P=0.000)。结论颅外标志可在术中为术者提供准确、客观、易于观察的参考,从而最大限度减少人为主观性影响,增加一次性穿刺成功率,在颅脑损伤患者较多的基层医院值得推广。

Objective To explore the clinical application of performing a frontal puncture of the lateral ventricleguided by extracranial marker in patients with severe traumatic brain injury.Methods A total of 153 cases with severe traumatic brain injury were randomly assigned to either an observation group(extracranial landmark-guided frontal puncture of the lateral ventricle,n=81)or a control group(conventional frontal puncture of the lateral ventricle,n=72),and the puncture success rates between the two groups were compared.Results Among the 81 patients in the observation group,76 had successful punctures,yielding a success rate of 93.83%.In the control group,51 out of 72 patients achieved successful punctures,resulting in a success rate of 70.83%.The puncture success rate in the observation group was significantly higher than that in the control group,and this difference was statistically significant(χ2=14.287,P<0.001).Conclusion The use of extracranial landmarks during surgery provides surgeons with precise,objective,and easily observable reference points,thereby minimizing the impact of human subjectivity and enhancing the first-time puncture success rate.This technique is particularly promising for wider adoption in primary care hospitals where severe head injuries are frequently encountered.