摘要
目的探究影响动脉瘤术中侧脑室额角穿刺损伤发生的相关危险因素。方法收集山西医科大学附属山西大医院神经外科自2017年1月至2018年10月收治的97例开颅夹闭动脉瘤术中行侧脑室额角穿刺患者的临床资料及CT测算数据。根据有无损伤分为穿刺损伤组(26例)和穿刺无损伤组(71例),比较2组患者的临床资料,并利用单因素和多因素Logistic回归分析确定发生损伤的危险因素。结果单因素分析结果显示,2组患者的入院GCS评分、Fisher分级、术前较小脑室、穿刺点距外侧裂距离、穿刺点距眶顶距离、中线偏移比较,差异有统计学意义(P<0.05);多因素Logistic回归分析发现术前较小脑室(OR=10.232,95%CI:1.475~70.961)、Fisher分级越高(OR=11.527,95%CI:2.235~59.462)和穿刺点距外侧裂距离较近(OR=2.384,95%CI:1.106~5.137)为侧脑室穿刺损伤的危险因素。结论术前脑室较小、Fisher分级较高、穿刺点距外侧裂距离较近为穿刺损伤的危险因素。因此,对于脑室较小、Fisher分级较高且有脑组织结构移位者,建议在辅助引导下穿刺。
Objective To investigate the relevant risk factors of lateral ventricular frontal angle puncture injury during intracranial aneurysm operation.Methods The clinical data and CT data of 97 patients who underwent lateral ventricular frontal angle puncture during craniotomy and clipping of aneurysms in Neurosurgery Department of Shanxi Dayi Hospital Affiliated to Shanxi Medical University from January 2017 to October 2018 were collected.According to the presence or absence of injury,the patients were divided into puncture injury group(26 cases)and puncture no injury group(71 cases).The clinical data of the two groups were compared,and the risk factors of injury were determined by univariate and multivariate Logistic regression analysis.Results Univariate analysis showed that GCS score,Fisher grade,preoperative smaller ventricle,the distance between puncture point and lateral fissure,distance between puncture point and orbital apex and midline deviation were compared between the two groups,the difference was statistically significant(P<0.05);Multivariate Logistic regression analysis found that the smaller ventricle(OR=10.232,95%CI:1.475-70.961),the higher Fisher grade(OR=11.527,95%CI:2.235-59.462)and the closer distance between puncture point and lateral fissure(OR=2.384,95%CI:1.106-5.137)were the risk factors of lateral ventricular puncture injury.Conclusion Smaller preoperative ventricles,higher Fisher grade and closer distance between puncture point and lateral fissure were the risk factors of puncture injury.For those with small ventricle,higher Fisher grade and brain tissue structure displacement,assisted-guided puncture is recommended.
作者
张东
梁宗星
陈来照
Zhang Dong;Liang Zongxing;Chen Laizhao(Department of Neurosurgery,Shanxi Dayi Hospital Affiliated to Shanxi Medical University,Taiyuan 030032,China)
出处
《中华神经创伤外科电子杂志》
2021年第6期355-358,共4页
Chinese Journal Of Neurotraumatic Surgery：Electronic Edition
关键词
颅内动脉瘤
蛛网膜下腔出血
脑室穿刺
危险因素
Intracranial aneurysm
Subarachnoid hemorrhage
Ventriculocentesis
Risk factors
