基于体表解剖标志的穿刺路径规划在老年丘脑内囊型出血引流术中的应用

Application of puncture path planning based on surface anatomical markers in elderly patients undergoing drainage surgery for thalamus and internal capsule hematoma

目的评价基于体表解剖标志的路径规划在老年丘脑内囊型出血血肿引流术中的应用价值。方法回顾性分析丘脑内囊型出血行引流手术的175例老年病人,其中接受体表解剖标志路径规划血肿引流术的91例病人纳入研究组,行立体定向血肿引流术的84例病人纳入对照组;比较2组病人路径规划时间、术后再出血情况、置管准确率、血肿清除率、术后并发脑积水、治疗有效率、预后良好率等指标间的差异。结果研究组与对照组路径规划时间分别为(7.4±2.6)min、(40.5±10.5)min,2组间差异有统计学意义(P<0.01);研究组与对照组置管准确率、术后再出血、血肿清除率、术后并发脑积水、治疗有效率、预后良好率比较,差异均无统计学意义(P>0.05)。结论基于体表解剖标志规划路径的血肿引流术治疗老年丘脑内囊型出血,方法简单,路径规划时间短,置管准确率高,手术效果与立体定向血肿引流术基本一致。

Objective To evaluate the application value of puncture path planning based on surface anatomical markers in the elderly patients undergoing drainage surgery for thalamus and internal capsule hematoma.Methods The clinical data of 175 elderly patients with thalamus and internal capsule hematoma who underwent drainage surgery were retrospectively analyzed.Among them,91 patients using surface anatomical landmarks to plan the puncture path for drainage were enrolled in the study group,and 84 patients receiving stereotactic hematoma drainage were enrolled in the control group.The differences in path planning time,postoperative rebleeding rate,catheter placement accuracy,hematoma clearance rate,postoperative concurrent hydrocephalus,treatment efficiency and good prognosis rate between the two groups were compared.Results The path planning time showed significant difference between the study group and the control group(7.4±2.6 min vs 40.5±10.5 min,P<0.01).There were no significant differences in catheter placement accuracy,postoperative rebleeding rate,hematoma clearance rate,postoperative concurrent hydrocephalus,treatment effectiveness and good prognosis rate between the study group and the control group(P>0.05).Conclusions The application of puncture path planning based on surface anatomical markers in the elderly patients undergoing drainage surgery for thalamus and internal capsule hematoma can shorten path planning time with accuracy.The surgical effect is consistent with stereotactic surgery.