梁锐　　方富　　吴维蒲

[摘要] 目的 觀察神经导航下变形脑室穿刺颅内压探头植入术的临床效果。 方法 选择2018年10月至2020年10月我院收治的脑出血患者40例，分为观察组和对照组，每组各20例，观察组行神经导航下变形脑室穿刺，对照组行传统常规下变形脑室穿刺颅内压探头植入术。比较两组患者穿刺指标（穿刺次数、穿刺成功率、置管位置、引流管置管时间）、格拉斯哥预后评分（GOS）、神经功能缺损评分（NIHSS）及并发症发生情况。 结果 观察组穿刺次数少于对照组，引流管留置时间短于对照组，置管位置良好率、穿刺成功率均高于对照组，差异有统计学意义（P<0.05）。两组患者术后GOS评分、NIHSS评分与术前比较，差异均有统计学意义（P<0.05）;观察组GOS评分高于对照组，NIHSS评分低于对照组，差异有统计学意义（P<0.05）。观察组患者穿刺损伤脑出血发生率低于对照组，差异有统计学意义（P<0.05），其他类型并发症发生率比较，差异无统计学意义（P>0.05）。 结论 神经导航辅助下变形脑室穿刺颅内压探头植入术是一种更加微创、精确地手术方法，具有一定的优势和疗效，有利于改善患者预后，值得临床推广和应用。

[关键词] 神经导航;变形脑室穿刺;颅内压探头植入术;格拉斯哥预后评分;并发症

[中图分类号] R651.11          [文献标识码] B          [文章编号] 1673-9701（2021）09-0071-04

Clinical efficacy on the implantation of intracranial pressure probe in deformed ventricular puncture under neuronavigation

LIANG Rui   FANG Fu   WU Weipu

Department of Neurosurgery， Jiujiang No.1 People′s Hospital in Jiangxi Province， Jiujiang   332000， China

[Abstract] Objective To observe the clinical efficacy of implantation of intracranial pressure probe in deformed ventricular puncture under neuronavigation. Methods A total of 40 patients with cerebral hemorrhage admitted to our hospital from October 2018 to October 2020 were selected， and they were divided into the observation group（n=20） and the control group（n=20）. The observation group was treated with implantation of intracranial pressure probe under deformed ventricular puncture with neuronavigation， while the control group was treated with that under conventional deformed ventricular puncture. The puncture indexes（puncture times， puncture success rate， catheterization position， drainage tube catheterization time）， glasgow outcome scale（GOS）， neurological deficit score（NIHSS） and complications were compared between the two groups of patients. Results The number of puncture in the observation group was less than that in the control group， the indwelling time of drainage tube was shorter than that in the control group， and the good position rate and success rate of puncture in the observation group were higher than those in the control group， the differences were statistically significant（P<0.05）. After operation， the GOS scores and NIHSS score of the two groups were significantly different from those before operation（P<0.05）; GOS score of observation group was higher than that of control group， NIHSS score was lower than that of control group， the differences were statistically significant（P<0.05）. The incidence of puncture injury cerebral hemorrhage in the observation group was lower than that in the control group， the difference was statistically significant（P<0.05）， and there was no significant difference in the incidence of other types of complications（P>0.05）. Conclusion The implantation of intracranial pressure probe under neuronavigation is a more minimally invasive and accurate surgical method， which has certain advantage and therapeutic efficacy， is conducive to improving the prognosis of patients， and is worthy of clinical promotion and application.

[Key words] Neuronavigation; Deformed ventricular puncture; Implantation of intracranial pressure probe; Glasgow outcome scale score; Complication

作为神经外科常见病，自发性脑出血发病凶险、病情变化快、病死率和致残率高，超过70%患者发生早期血肿扩大或累及脑室系统，随着脑血肿、脑肿胀的扩大及颅内压增高中线移位，脑室系统会随之发生变形移位，脑室出血偏大或脑室受压变小[1]。临床针对变形脑室多采用脑室穿刺置管引流，常见手段为脑室额角穿刺，其穿刺操作主要依赖体表解剖定位及临床操作者经验，存在盲目性，难以有效控制穿刺管深度，一次性穿刺成功率低[2]。……