3D Slicer技术辅助下行神经内镜下血肿清除术治疗高血压脑出血的临床效果

Clinical effect of 3D Slicer technique-assisted neuroendoscopic hematoma removal on hypertensive cerebral hemorrhage

目的观察3D Slicer技术辅助下行神经内镜下血肿清除术治疗高血压脑出血的临床效果。方法将60例高血压脑出血患者随机分为内镜组和开颅组,每组30例。内镜组采用3D Slicer技术辅助下行神经内镜下颅内血肿清除术治疗,开颅组采用传统开颅血肿清除术治疗。比较两组患者手术时间、术中出血量、血肿清除率、血肿消失时间、术后6个月并发症发生率、住院期间死亡率,以及治疗前后格拉斯哥昏迷量表(GCS)评分和改良Rankin量表(mRS)评分。结果两组患者住院期间均无死亡病例发生。内镜组患者手术时间、术中出血量、血肿消失时间及术后6个月并发症发生率均短于或少于开颅组,血肿清除率高于开颅组(均P<0.05)。治疗后,两组患者GCS评分均高于治疗前,mRS评分均低于治疗前,且内镜组GCS评分高于开颅组,mRS评分低于开颅组(均P<0.05)。结论相较于传统开颅手术,3D Slicer技术辅助下行神经内镜下血肿清除术手术定位更快速、准确,患者手术时间和术中出血量更少,血肿清除率更高,术后并发症发生率更低,更有利于患者神经功能的恢复。

Objective To observe the clinical effect of 3D Slicer technique-assisted neuroendoscopic hematoma removal on hypertensive cerebral hemorrhage.Methods Sixty patients with hypertensive cerebral hemorrhage were randomly divided into endoscopy group and craniotomy group,with 30 cases in each group.The endoscopy group was treated with 3D Slicer technique-assisted neuroendoscopic intracranial hematoma removal,and the craniotomy group was treated with traditional hematoma removal with craniotomy.Operation duration,intraoperative blood loss,hematoma clearance rate,duration for hematoma disappeared,incidence rate of postoperative 6-month complications,mortality during hospitalization,as well as the Glasgow Coma Scale(GCS)scores and modified Rankin Scale(mRS)scores before and after treatment were compared between the two groups.Results There were no deaths during hospitalization in the two groups.The endoscopy group had shorter operation duration,less intraoperative blood loss,shorter duration for hematoma disappeared,lower incidence rate of postoperative 6-month complications,and higher hematoma clearance rate as compared with the craniotomy group(all P<0.05).After treatment,GCS scores were higher and mRS scores were lower in both groups than those before treatment,and the endoscopy group exhibited higher GCS score and lower mRS score in comparison with the craniotomy group(all P<0.05).Conclusion Compared with traditional craniotomy,3D Slicer technique-assisted neuroendoscopic hematoma removal can provide surgical location more quickly and accurately,achieve less operation duration and intraoperative blood loss,higher hematoma clearance rate and lower incidence rate of postoperative complications in the patients,and is more conducive to the recovery of patients′neurological function.