颅内压监测联合3D打印技术治疗高血压脑出血的疗效

Efficacy of intracranial pressure monitoring combined with 3D printing technology in the treatment of hypertensive intracerebral hemorrhage

目的探讨颅内压监测联合3D打印技术在高血压脑出血患者中的临床应用。方法回顾性分析河南省人民医院神经外科2019-01—2021-04收治的应用3D打印技术治疗的83例高血压基底节区脑出血患者,其中辅助使用颅内压监测43例,单纯使用3D打印技术40例。分析2组患者术后临床治疗效果(GOS评分)、不良事件发生率(脑疝、二次开颅手术、颅内感染、肾功能损伤)。结果颅内压监测联合3D打印组GOS分级Ⅰ级2例,Ⅱ级4例,Ⅲ级4例,Ⅳ级22例,Ⅴ级11例,其中恢复良好(Ⅳ级+Ⅴ级)33例,良好率76.7%。3D打印组GOS分级Ⅰ级4例,Ⅱ级6例,Ⅲ级14例,Ⅳ级10例,Ⅴ级6例,其中恢复良好16例,良好率40.0%,2组临床有效率比较差异有统计学意义(P<0.05)。颅内压监测联合3D打印组术后不良事件发生率明显低于3D打印组,差异有统计学意义(P<0.05)。结论颅内压监测是3D打印微创穿刺治疗高血压基底节区脑出血的有效辅助方式。

Objective To investigate the clinical application of intracranial pressure monitoring combined with 3D printing technology in patients with hypertensive intracerebral hemorrhage.Methods A total of 83 patients with hypertensive basal ganglia hemorrhage treated with 3D printing technique from January 2019 to April 2021 in Henan Provincial People’s Hospital were analyzed retrospectively,including 43 patients who were assisted with intracranial pressure monitoring and 40 patients who were treated with 3D printing technique alone.Postoperative clinical treatment effect(GOS score)and incidence of adverse events(brain hernia,second craniotomy,intracranial infection,renal impairment)were analyzed in both groups.Results In the intracranial pressure monitoring combined with 3D printing group,there were 2 cases of GOS gradeⅠ,4 cases of gradeⅡ,4 cases of gradeⅢ,22 cases of gradeⅣ,and 11 cases of gradeⅤ.Among them,33 cases recovered well(gradeⅣ+Ⅴ),with a good rate of 76.7%.In the 3D printing group,there were 4 cases of GOS gradeⅠ,6 cases of gradeⅡ,14 cases of gradeⅢ,10 cases of gradeⅣ,and 6 cases of gradeⅤ,of which 16 cases recovered well,with a good rate of 40%,and the difference in the clinical effective rate between the two groups was statistically significant(P<0.05).The incidence of postoperative adverse events in the intracranial pressure monitoring combined with 3D printing group was significantly lower than that in the 3D printing group,and the difference was statistically significant(P<0.05).Conclusion Intracranial pressure monitoring is an effective auxiliary method for 3D printed minimally invasive puncture in the treatment of hypertensive basal ganglia hemorrhage.