摘要：

目的 探讨机器人无框架立体定向手术辅助系统（ROSA）辅助下脑深部电极植入术的准确性和安全性。方法 共6 例未能准确定位致灶的癫痫患者均行ROSA 机器人辅助下脑深部电极植入术，术后复查CT 和MRI，记录电极偏差的最大距离和最小距离，计算平均值，以评价手术准确性；术中记录电极相关出血事件，术后随访时复查CT 或MRI 记录电极相关出血或缺血事件及并发症发生情况，以评价手术安全性。结果 6 例患者术前计划植入电极37 根，术中实际植入37 根，成功率达100%。植入电极主要分布于颞叶内侧、海马和岛叶（5 例）、顶枕叶（1 例）。电极尖端最大偏差距离为8.79 mm、最小偏差距离为1.14 mm，平均（3.65 ± 1.82）mm。术中无一例发生电极相关出血事件，术后复查头部CT 和MRI 均未见电极相关出血或缺血事件。术后随访3 ~ 5 个月（平均3.67 个月），均未发生颅内感染、电极折断、头皮愈合不良、伤口感染等并发症。结论 ROSA 机器人辅助下脑深部电极植入术简便、快捷，电极植入准确性高、安全性佳。

关键词: 癫痫, 电极, 植入, 立体定位技术

Abstract:

Objective  To evaluate the accuracy and safety of deep brain electrode implantation assisted by robotized stereotactic assistant (ROSA) system. Methods  A total of 6 epileptic patients who had difficulty in positioning of epileptogenic focus underwent deep brain electrode implantation assisted by ROSA system. Record the maximum and minimum distance of electrode deviation according to postoperative CT and MRI and calculate the average distance, so as to evaluate the accuracy of operation. Record intraoperative electrode related bleeding events, postoperative electrode related bleeding or ischemic events and complications during the follow-up period, so as to evaluate the safety of operation. Results  A total of 37 electrodes were successfully implanted in all 6 cases, with a success rate of 100%. Implanted electrodes were mainly located in medial temporal lobe, hippocampus and insular lobe (5 cases) and parieto-lobe (one case). The maximum deviation distance was 8.79 mm, and minimum was 1.14 mm, with an average of (3.65 ± 1.82) mm. Neither intraoperative electrode related bleeding event nor postoperative electrode related bleeding or ischemic event was found. No patient suffered from severe complications, such as intracranial infection, electrode disjunction, undesirable healing of scalp and wound infection, during the follow-up period from 3 to 5 months (mean 3.67 months). Conclusions  Deep brain electrode implantation assisted by ROSA system is safe and accurate.

Key words: Epilepsy, Electrodes, implanted, Stereotaxic techniques