Neurosurgery is a highly specialized field:it often involves surgical manipulation of noble structures and cerebral retraction is frequently necessary to reach deep-seated brain lesions.There are still no reliable met...Neurosurgery is a highly specialized field:it often involves surgical manipulation of noble structures and cerebral retraction is frequently necessary to reach deep-seated brain lesions.There are still no reliable methods preventing possible retraction complications.The objective of this study was to design work chambers well suited for transcranial endoscopic surgery while providing safe retraction of the surrounding brain tissue.The chamber is designed to be inserted close to the intracranial point of interest;once it is best placed it can be opened.This should guarantee an appreciable workspace similar to that of current neurosurgical procedures.The experimental aspect of this study involved the use of a force sensor to evaluate the pressures exerted on the brain tissue during the retraction phase.Following pterional craniotomy,pressure measurements were made during retraction with the use of a conventional metal spatula with different inclinations.Note that,although the force values necessary for retraction and exerted on the spatula by the neurosurgeon are the same,the local pressure exerted on the parenchyma at the edge of the spatula at different inclinations varied greatly.A new method of cerebral retraction using a chamber retractor(CR)has been designed to avoid any type of complication due to spatula edge overpressures and to maintain acceptable pressure values exerted on the parenchyma.展开更多
目的:探讨压舌板辅助手法放置可弯曲喉罩的可行性。方法:选择拟于可弯曲喉罩全麻下行择期手术的患者64例,性别不限,年龄18~80岁,ASAⅠ~Ⅲ级。采用随机信封法将其分为标准手指引导组和压舌板辅助组,每组32例。分别记录两组喉罩置入时间...目的:探讨压舌板辅助手法放置可弯曲喉罩的可行性。方法:选择拟于可弯曲喉罩全麻下行择期手术的患者64例,性别不限,年龄18~80岁,ASAⅠ~Ⅲ级。采用随机信封法将其分为标准手指引导组和压舌板辅助组,每组32例。分别记录两组喉罩置入时间、口咽部泄露压、纤维支气管镜视野评分和首次置管成功率及术后24 h内咽痛的发生情况。结果:最终62例患者的资料纳入统计分析,标准手指引导组31例、压舌板辅助组31例。压舌板辅助组患者纤维支气管镜视野评分高于标准手指引导组( Z =-4.241, P <0.001);压舌板辅助组口咽部泄露压高于标准手指引导组( t =-4.474, P <0.001)。与标准手指引导组患者相比,压舌板辅助组置管时间较长( t =-15.171, P <0.001)。压舌板辅助组首次置管成功率(100%)与标准手指引导组(93.55%)差异无统计学意义。两组患者术后24 h内均未发生咽痛情况。结论:压舌板辅助法置入可弯曲喉罩可明显提高喉罩对位准确率,提高喉罩口咽部密闭性,且不增加术后咽痛的发生率,值得在临床工作中推广应用。展开更多
文摘Neurosurgery is a highly specialized field:it often involves surgical manipulation of noble structures and cerebral retraction is frequently necessary to reach deep-seated brain lesions.There are still no reliable methods preventing possible retraction complications.The objective of this study was to design work chambers well suited for transcranial endoscopic surgery while providing safe retraction of the surrounding brain tissue.The chamber is designed to be inserted close to the intracranial point of interest;once it is best placed it can be opened.This should guarantee an appreciable workspace similar to that of current neurosurgical procedures.The experimental aspect of this study involved the use of a force sensor to evaluate the pressures exerted on the brain tissue during the retraction phase.Following pterional craniotomy,pressure measurements were made during retraction with the use of a conventional metal spatula with different inclinations.Note that,although the force values necessary for retraction and exerted on the spatula by the neurosurgeon are the same,the local pressure exerted on the parenchyma at the edge of the spatula at different inclinations varied greatly.A new method of cerebral retraction using a chamber retractor(CR)has been designed to avoid any type of complication due to spatula edge overpressures and to maintain acceptable pressure values exerted on the parenchyma.
文摘目的:探讨压舌板辅助手法放置可弯曲喉罩的可行性。方法:选择拟于可弯曲喉罩全麻下行择期手术的患者64例,性别不限,年龄18~80岁,ASAⅠ~Ⅲ级。采用随机信封法将其分为标准手指引导组和压舌板辅助组,每组32例。分别记录两组喉罩置入时间、口咽部泄露压、纤维支气管镜视野评分和首次置管成功率及术后24 h内咽痛的发生情况。结果:最终62例患者的资料纳入统计分析,标准手指引导组31例、压舌板辅助组31例。压舌板辅助组患者纤维支气管镜视野评分高于标准手指引导组( Z =-4.241, P <0.001);压舌板辅助组口咽部泄露压高于标准手指引导组( t =-4.474, P <0.001)。与标准手指引导组患者相比,压舌板辅助组置管时间较长( t =-15.171, P <0.001)。压舌板辅助组首次置管成功率(100%)与标准手指引导组(93.55%)差异无统计学意义。两组患者术后24 h内均未发生咽痛情况。结论:压舌板辅助法置入可弯曲喉罩可明显提高喉罩对位准确率,提高喉罩口咽部密闭性,且不增加术后咽痛的发生率,值得在临床工作中推广应用。
