关键词: 脑内血肿, 穿刺引流, 立体定位, 神经外科

Abstract: Objective This study aimedto introduce a simple stereotactic puncture method for intracerebral hematoma.Methods Sixty patients with intracerebral supratentorial hemorrhage were treated by hematoma puncture with a simple stereoscopic positioning method in the Neurosurgery Department of Zibo First Hospital between January 2019 and October 2021.Cranial CT,square,metric,marker,and other tools were used to mark the three-dimensional projection of the puncture target and its coronal,sagittal,and axial plane on the patient's body surface before surgery.The line between the surgical site and the body surface projection of the puncture target was drawn as the auxiliary line to determine the puncture direction,and the puncture depth was calculated according to the body surface measurement results to guide and complete the puncture.Results The range of puncture error was 0~29 mm,with an average of 8.4±7.1 mm.The duration of hematoma drainage was 0~10 days,with an average of 3.6±1.8 days.The frequency of urokinase injection ranged from 0 to 10 times,with an average of 4.0±2.2 times.Preoperative hematoma volume ranged from 12.0 to 135.3ml,averaging 49.2±24.9 ml.Postoperative residual hematoma volume ranged from 1.0 ml to 35.4ml,averaging 9.7±9.3 ml.The percentage of residual hematoma ranged from 2% to 69%,with an average of 20.9±16.8%.Preoperative GCS scores ranged from 3 to 15 points,averaging 9.3±3.3 points.Postoperative exacerbation occurred in 5 patients,and one patient died.The GCS scores of the surviving patients at discharge ranged from 4 to 15,with a mean of 12.3±2.9 and a mean improvement of 3.0±3.3.Conclusion The simple three-dimensional positioning puncture method is a simple and practical surgical method with high accuracy and good drainage effect,especially for midline lesions.It has unique advantages and is suitable for widespread promotion.

Key words: Intracerebral hemorrhage, Puncture, Stereotaxy, Surgery