自制小脑幕定位仪在坐位经幕下小脑上手术入路中的应用

Application of Self-Made Tentorial-Locator in Sitting Position Through Infra-Fentorial Supra-Eerebellar Approach

目的:初步探讨自制小脑幕定位仪在神经外科患者行坐位经幕下小脑上手术入路中的应用效果。方法:将30例经坐位幕下小脑上手术入路的患者随机分为研究组和对照组,每组各15例,两组进行坐位摆放时手术床的调整方法和患者躯干体位摆放方法相同,研究组使用定位仪对患者的小脑幕进行定位并作好标记线,摆放头部前屈位时,使标记线与地面平行;对照组采用传统头部定位法,保持下颌骨和胸骨两横指。结果:研究组在摆体位时间、术野出血量、手术时间上明显少于对照组(P<0.05),研究组在手术野暴露、医生满意度、术后并发症的发生率上明显优于对照组(P<0.05)。结论:小脑幕定位仪定位准确、操作简单、安全无创,在神经外科坐位幕下小脑上入路手术中有很好的应用效果,值得推广。

Objective:To applicate a self-made tentorial-locator in sitting position through infra-tentorial supra-cerebella approach in neurosurgical patients.Methods:Thirty patients who received infratentorial supra-cerebella approaches in sitting positions were randomly divided into study group and control group,with 15 cases in each group.When the sitting-position were placed during neurosurgical operations,the two groups have the same trunk placement and adjustment methods.the study group used the locators to locate the tentoriums of each patient and mark them,then the head was flexed to make the mark-line horizontal.While the control group used the traditional head-positioning methods,which is to keep the mandible two finger away from the sternum.Results:The research group showed that the positioning time,the bleeding volume and the operation time were significantly decreased when comparing with the control group(P<0.05).The results of surgical field exposure,doctors’ satisfaction,the incidence of postoperative complications were significantly better than the control group(P<0.05).Conclusion:The self-made tentorial-locator was proved to be accurate,convenient for operation,safe and non-invasive.Itshows good effects in sitting position through infra-tentorial supra-cerebellar approaches,and it is worthy of marketing promotion.