ROSA辅助定向手术治疗高血压性脑干出血

摘要

目的 分析立体定向手术机器人(Robot of Stereotactic Assistant,ROSA辅助定向手术治疗高血压脑干出血的手术疗效.方法 回顾性分析33例高血压脑干出血的病例资料,均经微创手术治疗,根据时问节点分为框架辅助组17例(2014年1月-2016年3月)与ROSA辅助组16例(2016年5月-10月).结果 ROSA辅助组血肿清除率优于框架辅助组(P=0.031),ROSA辅助组手术时问与术后拔管时问均少于框架辅助组(分别为t=1.762,P<0.05;t=2.493,P<0.05).框架辅助组术后再出血3例,颅内感染2例;ROSA辅助组无再出血和颅内感染,但两组差异无统计学意义(分别为P=0.125和P=0.258).结论 ROSA辅助微创手术治疗高血压性脑干出血在血肿清除率、手术时问、术后拔管时问等方面,均优于框架立体定向辅助治疗,适用于高血压性脑干出血的超早期治疗.%Objective To analyze Robot of Stereotactic Assistant (ROSA) system assisted stereotactic surgery for the treatment of hypertensive brainstem hemorrhage. Methods The clinical data of 33 patients with hypertensive brainstem hemorrhage undergoing minimally invasive surgery were analyzed retrospectively. According to the time node, the patients were divided into frame group (n=17, stereotactic frame assisted, January 2014 to March 2016) and ROSA group (n=16, ROSA assisted, May to October 2016). Results The hematoma evacuation rate was higher in ROSA group than in frame group (P=0.031). The operation time and postoperative extubation time were shorter in ROSA group than in frame group (t=1.762, P<0.05;t=2.493, P<0.05 respectively). The postoperative hemorrhage occurred in 3 cases and intracranial infection in 2 in frame group, while did not occur in ROSA group, and the difference was not statistically significant between the two groups (P=0.125, P=0.258 respectively). Conclusions The hematoma evacuation rate, operation time and postoperative extubation time is superior in ROSA system assisted to stereotactic frame assisted minimally invasive surgical treatment for hypertensive brainstem hemorrhage. ROSA system is suitable for ultra-early treatment of hypertensive brainstem hemorrhage.