中等量高血压脑出血机器人辅助穿刺微创手术与保守治疗的临床研究

Clinical study of robot assisted minimally invasive surgery and conservative treatment for moderate hypertensive intracerebral hemorrhage

目的:探究中等量高血压脑出血机器人辅助穿刺微创手术与保守治疗比较。方法:选取2021年7月~2022年7月华中科技大学协和深圳医院100例中等量高血压脑出血患者,采用随机数字表法分为参照组(保守治疗)和试验组(机器人辅助穿刺微创手术)各50例,对干预效果进行比较。结果:试验组总有效率94.00%高于参照组72.00%,差异有统计学意义(P<0.05),试验组失血量、手术、血肿清除、脑脊液恢复、置管引流、住院时长均少于参照组,差异有统计学意义(P<0.05),手术后1 min、1 d、3 d试验组的颅内压小于参照组,差异有统计学意义(P<0.05),两组手术前的炎性因子比较,差异无统计学意义(P>0.05),试验组手术后的肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白介素-6(IL-6)均小于参照组,差异有统计学意义(P<0.05),研究对象手术前的神经功能缺损(NIHSS)、日常生活能力(ADL)、格拉斯昏迷评分(GCS)、格拉斯哥预后评分(GOS)比较,差异无统计学意义(P>0.05),试验组手术后的NIHSS评分低于参照组,但ADL、GCS、GOS评分高于参照组,差异有统计学意义(P<0.05)。结论:机器人辅助穿刺微创手术能够快速降低患者颅内压,并清除血肿,缩短住院天数,促进炎性反应消失,改善患者神经功能,促进预后。

Objective To explore the comparison between robot assisted minimally invasive surgery and conservative treatment for moderate to moderate hypertensive intracerebral hemorrhage.Method From July 2021 to July 2022,100 patients with moderate to equal amount of hypertensive intracerebral hemorrhage in Huazhong University of Science and Technology Union Shenzhen Hospital were selected and randomly divided into the reference group(conservative treatment)and the experimental group(robot assisted puncture minimally invasive surgery),50 cases in each group,and the intervention effects were analyzed and compared.Results The total effective rate of the experimental group was 94.00%,which was higher than that of 72.00%in the reference group(P<0.05).The amount of blood loss,operation,hematoma removal,cerebrospinal fluid recovery,catheter drainage and length of hospitalization in the experimental group were less than those in the reference group(P<0.05).The intracranial pressure in the experimental group was lower than that in the reference group at 1 minute,1 day,and 3 days after surgery(P<0.05).There was no difference in inflammatory factors between the two groups before operation(P>0.05).Tumor necrosis factor in the experimental group after operation-α(TNF-α),C-reactive protein(CRP)and interleukin-6(IL-6)were lower than those in the reference group(P<0.05).There was no difference in the neurological impairment(NIHSS),ability of daily living(ADL),Glasgow coma score(GCS)and Glasgow outcome score(GOS)of the subjects before surgery(P>0.05).The NIHSS score of the experimental group after surgery was lower than that of the reference group,but the ADL,GCS and GOS scores were higher than that of the reference group(P<0.05).Conclusion Robot assisted minimally invasive puncture surgery can rapidly reduce the intracranial pressure of patients,clear the hematoma,shorten the length of hospital stay,promote the disappearance of inflammatory reactions,improve the neurological function of patients,and promote the prognosis.