3D-slicer联合Sina/MosoCam软件辅助神经内镜治疗幕上高血压性脑出血的临床应用

Clinical application of 3D-slicer combined with Sina/MosoCam assisted neuroendoscopy in the treatment of supratentorial hypertensive intracerebral hemorrhage

目的探讨3D-slicer联合Sina/MosoCam软件辅助神经内镜治疗幕上高血压性脑出血的临床应用及效果。方法选取2019年6月至2021年9月武汉大学人民医院神经外科收治的50例幕上高血压性脑出血患者。根据手术入路的设计及选择分为3D-slicer组(21例)和CT组(29例)。CT组采用CT辅助定位;3D-slicer组采用3D-slicer联合Sina/MosoCam软件进行手术入路设计及选择。比较两组术后第1天血肿清除率、手术时间、术后再出血发生率、置管时间、颅内感染率、出院时格拉斯哥昏迷量表(GCS)评分及脑卒中改良Rankin量表(mRS)评分。结果两组术后均未出现再出血患者。两组血肿清除率,手术时间比较,差异有统计学意义(P<0.05);两组颅内感染、置管时间、出院GCS评分及mRS评分比较,差异无统计学意义(P>0.05)。结论3D-slicer联合Sina/MosoCam软件辅助经颅神经内镜治疗高血压性脑出血在术前设计手术入路及术后评估方面具有指导意义,在整体疗效上一定优势。

Objective To investigate the clinical application and efficacy of 3D-slicer combined with Sina/MosoCam assisted neuroendoscopy in the treatment of supratentorial hypertensive intracerebral hemorrhage.Methods A total of 50 patients with supratentorial hypertensive intracerebral hemorrhage admitted to the Department of Neurosurgery,People Hospital of Wuhan University from June 2019 to September 2021 were selected.According to the design and selection of surgical approach,the patients were divided into 3D-slicer group(21 cases)and CT group(29 cases).CT group used CT-assisted localization,in the 3D-slicer group,3D-slicer combined with Sina/MosoCam software was used for surgical approach design and selection.The hematoma clearance rate on the 1st postoperative day,operation time,postoperative rebleeding rate,catheterization time,intracranial infection rate,Glasgow coma scale(GCS)score and modified Rankin scale(mRS)score at discharge were compared between the two groups.Results There was no rebleeding in the two groups.There were statistically significant differences in hematoma clearance rate and operation time between two groups(P<0.05).There were no significant differences in intracranial infection,catheterization time,discharge GCS score,and mRS score between two groups(P>0.05).Conclusion 3D-slicer combined with Sina/MosoCam software assisted neuroendoscopy in the treatment of hypertensive intracranial hemorrhage has guiding significance in preoperative surgical approach design and postoperative evaluation,and has certain advantages in overall efficacy.