基于虚拟现实与增强现实结合内镜行脑内血肿清除临床疗效观察

The study on effect of endoscopic hematoma removal based on virtual reality and augmented reality

目的探讨基于虚拟现实与增强现实结合内镜下脑内血肿清除术在自发性脑出血患者中的临床效果。方法选择2017年7月至2019年6月自发性脑出血患者120例作为对象,随机数字表分为对照组(n=60例)和观察组(n=60例)。对照组采用开颅手术治疗,观察组采用基于虚拟现实与增强现实结合内镜下脑内血肿清除术治疗,术后对患者进行30 d随访,比较两组血肿清除率、手术指标、格拉斯哥昏迷评分(GCS)、死亡率及术后并发症发生率。结果观察组手术时间(61.43±4.51)min、手术切口(4.33±0.79)cm、术中出血量(12.24±2.31)mL及住院时间(17.34±2.41)d,对照组手术时间(132.59±6.74)min、手术切口(18.32±3.23)cm、术中出血量(204.23±5.34)mL及住院时间(22.49±3.98)d,观察组均少(短)于对照组(P均<0.01);观察组血肿清除率(87%±10%)高于对照组(75%±7%)(t=0.416,P<0.01);两组治疗前GCS量表评分无统计学意义(P>0.05);观察组治疗后2周11(9,13)分、治疗后4周12(10,14)分,对照组疗后2周10(8,12)分、治疗后4周11(8,12)分,均高于治疗前(P<0.05);观察组治疗后2周、4周GCS量表评分高于对照组(P<0.05);观察组术后死亡率3.33%,对照组5.00%,差异无统计学意义(P>0.05);观察组切口感染1.67%、多脏器衰竭3.33%、再出血发生率1.67%,对照组切口感染6.67%、多脏器衰竭8.33%、再出血发生率6.67%均低于对照组(P均<0.05)。结论基于虚拟现实与增强现实结合内镜下脑内血肿清除术用于自发性脑出血患者中能提高血肿清除率,能改善患者昏迷状态,降低临床死亡率及并发症发生率。

Objective To explore the clinical effects of endoscopic hematoma removal in patients with spontaneous cerebral hemorrhage based on virtual reality and augmented reality.Methods One hundred twenty patients with spontaneous cerebral hemorrhage from July 2017 to June 2019 were selected as subjects,and Patients were divided into the control group(n=60 cases)and the observation group(n=60 cases)using random number table.The control group received craniotomy and the study group received virtual reality-and augmented reality-based endoscopic hematoma removal.The patients were followed up for 30 days.The hematoma clearance rate,surgical indicators,Glasgow coma,incidence of postoperative complications and death were compared between the two groups.Results Compared with control group,The operation time(61.43±4.51 vs.132.59±6.74 min)and hospital stay(17.34±2.41 vs.22.49±3.98 d)were much shorter;intraoperative blood loss(12.24±2.31 vs.204.23±5.34 mL)was much less and surgical incision(4.33±0.79 vs.18.32±3.23 cm)were much smaller in the study group(all P<0.01).The hematoma clearance rate in study group(87%±10%)was higher than that in the control group(75%±7%)(t=0.416,P<0.01).The GCS scale scores before treatment in the two groups were not statistically significant(P>0.05).GCS scale scores were much higher in the study group compared with control group at 2 weeks[11(9,13)vs.10(8,12)],4 weeks[12(10,14)vs.11(8,12)]after treatment(P<0.05).Postoperative mortality was not statistically significant between the study group(3.33%)and control group(5.00%)(P>0.05).Compared with control group,incision infection(1.67%vs.6.67%),multiple organ failure(3.33%vs.8.33%)and the incidence of rebleeding(1.67%vs.6.67%)were much lower in study group(all P<0.05).Conclusion Endoscopic hematoma removal based on virtual reality and augmented reality can improve hematoma clearance rate in patients with spontaneous cerebral hemorrhage,improve coma,reduce clinical mortality and complication rate.