3D-Slicer软件辅助神经内镜颅内血肿清除术与开颅手术治疗长轴型高血压性基底核区出血临床效果的对比研究

摘要

Objective To compare the clinical effect on long-axis type hypertensive basal ganglia hemorrhage between 3D-slicer software assisted neuroendoscopic intracranial hematoma evacuation and craniotomy.Methods From January 2015 to January 2017,a total of 81 patients with long-axis type hypertensive basal ganglia hemorrhage were selected in the Department of Neurosurgery,Traditional Chinese Medicine Hospital of Ankang,and they were divided into A group (n =33) and B group (n =48) according to the surgical procedures.Patients of A group received 3D-slicer software assisted neuroendoscopic intracranial hematoma evacuation,while patients of B group received craniotomy.Duration of surgery,intraoperative blood loss,postoperative recurrence of hemorrhage,hematoma clearance rate,ICU stays,GCS score after 7 days of surgery and ADL grading after 6 months of surgery were compared between the two groups.Results Duration of surgery and ICU stays of A group were statistically significantly shorter than those of B group,intraoperative blood loss of A group wasstatistically significantly less than that of B group,hematoma clearance rate of A group was statistically significantly higher than that of B group,GCS score after 7 days of surgery of A group was statistically significantly higher than that of B group (P ＜0.05),while no statistically significant differences of incidence of postoperative recurrent hemorrhage was found between the two groups (P ＞ 0.05).ADL grading of A group was statistically significantly better than that of B group after 6 months of surgery (P ＜ 0.05).Conclusion Compared with craniotomy,3D-slicer software assisted neuroendoscopic intracranial hematoma evacuation can effectively shorten the duration of surgery and ICU stays in patients with long-axis type hypertensive basal ganglia hemorrhage,reduce the intraoperative blood loss,improve the hematoma clearance rate,neurological function and prognosis.%目的 比较3D-Slicer软件辅助神经内镜颅内血肿清除术与开颅手术治疗长轴型高血压性基底核区出血的临床效果.方法 选取2015年1月-2017年1月安康市中医医院神经外科收治的长轴型高血压性基底核区出血患者81例,根据手术方式分为A组33例和B组48例.A组患者行3D-Slicer软件辅助神经内镜颅内血肿清除术,B组患者行开颅手术.比较两组患者手术时间、术中出血量、术后再出血发生情况、血肿清除率、重症监护时间、术后7d格拉斯哥昏迷量表(GCS)评分、术后6个月日常生活活动能力量表(ADL)分级.结果 A组患者手术时间、重症监护时间短于B组,术中出血量少于B组,血肿清除率高于B组,术后7 d GCS评分高于B组(P＜0.05);两组患者术后再出血发生率比较,差异无统计学意义(P＞0.05).术后6个月A组患者ADL分级优于B组(P＜0.05).结论 与开颅手术相比,3D-Slicer软件辅助神经内镜颅内血肿清除术可有效缩短长轴型高血压性基底核区出血患者手术时间和重症监护时间,减少术中出血量,提高血肿清除率,改善患者神经功能及预后.