高血压性脑出血微创手术治疗中3D Slicer的应用效果研究

Research on effectiveness of 3D Slicer for treating patients with hypertensive intracerebral hemorrhage in minimally invasive surgery

目的研究高血压性脑出血(HICH)微创手术治疗中3D Slicer的应用效果。方法150例高血压性脑出血患者按采用的手术治疗方法不同,分为3D Slicer软件辅助神经内镜微创手术组(内镜微创组)和传统开颅手术组(对照组),每组各75例。对比两组患者的手术时间、血肿清除率等手术相关指标,以及术后清醒时间、再出血及预后状况。结果内镜微创组患者的血肿清除率明显高于对照组、手术时间和再出血率低于对照组(P<0.05~0.005);术后清醒时间和改良Rankin量表(mRS)评分明显低于对照组,格拉斯哥昏迷量表(GCS)评分显著高于对照组,术后并发症发生率明显低于对照组,格拉斯哥预后量表(GOS)评分显著优于对照组(P<0.05~0.001)。结论应用3D Slicer软件辅助内镜微创手术治疗高血压性脑出血,能够显著发挥微创手术治疗和软件定位的优势,能使手术相关指标和血肿清除效果得到显著提高;同时还有助于降低手术创伤,改善患者的预后。

Objective To study the effect of 3D Slicer in minimally invasive surgery for hypertensive intracerebral hemorrhage(HICH).Methods 150 patients with HICH were divided into 3D Slicer software assisted neuroendoscopic minimally invasive surgery group(endoscopic minimally invasive group)and traditional craniotomy group(control group),with 75 cases in each group.The operation time,hematoma clearance rate and other operation related indexes,as well as postoperative awake time,rebleeding and prognosis were compared between the two groups.Results The clearance rate of hematoma in the endoscopic minimally invasive group was significantly higher than that in the control group,and the operation time and rebleeding rate were lower than those in the control group(P<0.05~0.005).The postoperative awake time and modified Rankin scale(MRS)score were significantly lower than those in the control group,the Glasgow coma scale(GCS)score was significantly higher than those in the control group,the incidence of postoperative complications was significantly lower than those in the control group,and the Glasgow prognosis scale(GOS)score was significantly better than those in the control group(P<0.05~0.001).Conclusions The application of 3 D Slicer software assisted endoscopic minimally invasive surgery in the treatment of HICH can significantly give play to the advantages of minimally invasive surgery and software positioning,and significantly improve the operation related indexes and hematoma removal effect;It also helps to reduce surgical trauma and improve the prognosis of patients.