国产神经外科医疗机器人Remebot治疗高血压性脑出血

摘要

目的 验证国产神经外科机器人定位系统Remebot治疗高血压性脑出血的有效性与安全性.方法 回顾性分析3例高血压性脑出血病人的临床资料,均应用Remebot无框架定位血肿排空置管引流术,术后配合尿激酶血肿腔注射引流.置2枚引流管1例,置1枚引流管2例.结果 引流2d后血肿完全排空2例,血肿明显减小1例.随访1~2年,病人肢体肌力恢复至4级1例;恢复至5级1例;术后反复出血1例,确诊为血小板无力症,予输注血小板后停止出血,该病人共经历4次开颅手术,左侧肢体全瘫.结论 国产神经外科机器人导航定位系统Remebot创伤小、定位准确度高,可根据血肿形态进行手术规划,适用于高血压性脑出血置管引流及血肿排空手术.对血肿量较少但功能影响较重的病人,应尽早排空血肿,以利于恢复功能.%Objective To verify the effectiveness and safety of domestic neurosurgery medical robot Remebot for the treatment of hypertensive cerebral hemorrhage (HCH). Methods Clinical data of 3 HCH patients were analyzed retrospectively. Hematoma evacuation and tube drainage with Remebot frameless stereotaxy were performed in all the patients, and urokinase was injected into hematoma after the operation. Two drainage tubes were implanted in 1 patient and 1 drainage tube in 2. Results Hematoma disappeared in 2 patients and significantly reduced in 1 after 2 days of drainage. During a follow-up period of 1 to 2 years, the muscle strength was recovered to grade 4 in 1 patient and grade 5 in 1. While 1 patient was found to have repeated hemorrhage and diagnosed with thrombasthenia, then, platelets were transfused to stop bleeding, and craniotomy was performed for 4 times in this patient and the muscle strength of the left limb was grade 0. Conclusions The domestic neurosurgery medical robot Remebot is minimal invasive and high positional accuracy, and surgical planning can be made according to the shape of hematoma. It must be suitable for hematoma evacuation and tube drainage in HCH patients. For the patient with less hematoma but severe functional disability, hematoma evacuation should be performed as early as possible functional recovery.