PBC术中球囊压力与球囊形状、容积,Meckel’s腔解剖参数关系的研究*

Study on the relationship between balloon pressure and balloon shape, volume and anatomical parameters of Meckel"s cavity during PBC operation*

摘要:

目的：通过对PBC术中球囊压力与球囊形状、球囊容积,Meckel’s腔的长、宽、高,和体积关系的研究,探讨术中球囊压力变化的特点。方法：本研究回顾性分析了甘肃省人民医院神经外科2021年9月～2023年7月收治的行PBC手术治疗的51例原发性三叉神经痛患者的临床资料。应用3D-slicer软件建模并测算了所有患者的Meckel’s腔的长、宽、高,和体积；术中利用便携式压力测量仪监测记录患者球囊压力并记录造影剂容积。统计学分析术中球囊压力与球囊形状、容积,Meckel’s腔的长、宽、高,和体积的相关性。结果：本研究中“梨形”球囊术后疼痛缓解即刻有效率100%。其中55例“梨形”球囊压力峰值：166.23±12.84 kPa,末期压力：119.38±7.24 kPa,全程平均压力值为：137.69±1.58 kPa；6例“类梨形”球囊压力峰值：178.50±5.05 kPa,末期压力：124.50±11.82 kPa,全程平均压力值：150.33±1.51 kPa。类梨形球囊全程平均压力大于梨形球囊全程平均压力有统计学意义(P<0.05)。术中球囊压力峰值和压力平均值与术中球囊容积、Meckel’s腔的体积、和长不相关(P>0.05)。术中球囊压力峰值和压力平均值与球囊容积和Meckel’s腔的体积比值相关(P<0.05),与Meckel’s腔的宽,高相关(P<0.05)。术中球囊压力末值与球囊形状、容积、Meckel’s腔的长、宽、高,和体积不相关(P>0.05)。“梨形”球囊容积与Meckel’s腔的体积比值范围为：1.57±0.11，类梨形：1.68±0.08。结论：术中球囊压力与球囊形状、Meckel’s腔宽、高,和球囊容积与Meckel’s腔的体积比值存在相关性,术前测量Meckel’s腔体积可以在术中指导球囊压力以及球囊容积,提高手术疗效,降低手术并发症。

Abstract:

Objective: To study the relationship between balloon pressure and balloon shape, balloon volume, length, width, height and volume of Meckel's cavity during PBC operation, and to explore the characteristics of balloon pressure changes during PBC operation. Methods: The clinical data of 51 patients with primary trigeminal neuralgia treated with PBC from September 2021 to July 2023 in the Department of Neurosurgery of Gansu Provincial People's Hospital were retrospectively analyzed. 3D-slicer software was used to model and measure the length, width, height and volume of Meckel's cavity of all patients. Intraoperative balloon pressure was monitored and the volume of contrast agent was recorded with a portable pressure measuring instrument. The correlation between balloon pressure and balloon shape, volume, length, width, height, and volume of Meckel's cavity was statistically analyzed. Results: In this study, the immediate pain relief efficiency of "pear shaped" balloon was 100%. In 55 cases, the peak pressure of "pear-shaped" balloon was 166.23± 12.84kPa, the final pressure was 119.38± 7.24kPa, and the average pressure value of the whole process was 137.69± 1.58kPa. In 6 cases, the peak pressure of "pear-like" balloon was 178.50± 5.05kPa, the final pressure was 124.50± 11.82kPa, and the average pressure value of the whole process was 150.33± 1.51kPa. The average pressure of the pear-shaped balloon was higher than that of the pear-shaped balloon (P<0.05). The peak value and mean value of intraoperative balloon pressure were not correlated with intraoperative balloon volume, volume and length of Meckel's cavity (P>0.05). The peak value and mean value of intraoperative balloon pressure were correlated with the ratio of balloon volume to the volume of Meckel's cavity (P<0.05), and with the width and height of Meckel's cavity (P<0.05). The final value of intraoperative balloon pressure was not correlated with balloon shape, volume, length, width and height of Meckel's cavity, and volume (P>0.05). The volume ratio of the "pear-shaped" balloon to Meckel's cavity ranges from 1.57±0.11 to 1.68±0.08. Conclusions: Intraoperative balloon pressure is correlated with balloon shape, Meckel's cavity width and height, and the ratio of balloon volume to Meckel's cavity volume. Preoperative measurement of Meckel's cavity volume can guide balloon pressure and balloon volume during surgery, improve surgical efficacy and reduce surgical complications.