摘要
目的介绍Leksell框架引导下的立体脑电图(SEEG)电极植入技术在临床中的应用。方法通过对我院自2014年01月至2019年04月使用Leksell框架植入SEEG电极的49例难治性癫痫患者进行统计,对植入电极的误差、造成误差的因素及并发症等进行分析并总结经验。结果49例患者手术过程均顺利,2例患者术后出现无症状性硬膜外血肿,给予急诊下钻孔引流,1例少量硬膜下血肿,予以观察,3例患者均未影响进一步监测。49例患者共植入SEEG电极558根,人均电极11.4根,平均每根电极用时13.3 min,选取手术计划保存完整的患者共19例,其植入电极的入点误差1.49±0.93 mm,靶点误差2.63±1.57 mm,但有11根电极行程中出现明显弯曲,未纳入统计数据。49例患者中,47例术后脑电图监测成功定位致痫灶并行后续相关治疗。结论基于Leksell框架引导下的立体脑电图电极植入技术安全可靠,误差在允许范围之内,能够覆盖大脑半球各脑叶,满足立体定向脑电图的需要。
Objective To introduce the clinical application of SEEG implantation based on Leksell stereotactic frame.Methods Based on the statistics of 49 patients with refractory epilepsy implanted electrodes with Leksell framework in our hospital from January 2014 to April 2019,we have analyzed the errors of implanted electrodes,factors causing errors and complications and summarized experience.Results The surgery of 49 patients were successful,but two patients had asymptomatic epidural hematoma in postoperative surgery,and drilled drainage under emergency,one patient wao had a small amount of subdural hematoma was observed,but no one was affected further SEEG monitoring.The 49 patients have implanted 558 electrodes,per individual 11.4 electrodes,each electrode took 13.3 min.We choosed 19 patients whose datas were detailed record,and median entry point localization error was 1.49±0.93 mm,target point localization error was 2.63±1.57 mm.But there are 11 electrodes bending in the brain,and not included in the statistics.47 of 49 patients were successfully located epileptogenic foci during mornitoring and next stage treatments.Conclusion The technique ofSEEG implantation based on Leksell stereotactic frame is safe and reliable,with acceptable error,which can cover every brain lobe and meet the clinical needs.
作者
任杰
赵永彬
田杨
滕鹏飞
和磊洁
王东林
夏忠琼
周健
栾国明
Ren Jie;Zhao Yongbin;Tian Yang(The First Department of Neurosugery,Kunming Sanbo Brain Hospital,Kunming,650100,China)
出处
《立体定向和功能性神经外科杂志》
2020年第5期257-260,共4页
Chinese Journal of Stereotactic and Functional Neurosurgery
作者简介
通讯作者:任杰,renj@ccmu.edu.cn
