3D打印导航下脑干血肿穿刺外引流术治疗脑干出血的临床效果

Clinical effect of hematoma puncture and external drainage under 3D printing navigation in the treatment of brainstem hemorrhage

目的探讨3D打印导航下脑干血肿穿刺外引流术治疗脑干出血的临床效果。方法40例脑干出血患者,根据治疗方法的不同分为研究组及对照组,每组20例。研究组行3D打印导航下脑干血肿穿刺外引流术治疗,对照组行常规单纯微创穿刺治疗。比较两组患者术后引流时间、住院时间、出院前美国国立卫生研究院卒中量表(NIHSS)评分,随访6个月内的预后情况。结果研究组患者的术后引流时间(1.53±0.63)d、住院时间(13.05±1.66)d均短于对照组的(3.18±0.75)、(18.65±2.18)d,出院前NIHSS评分(9.25±1.53)分低于对照组的(12.66±2.01)分,差异具有统计学意义(P<0.05)。随访6个月,研究组患者恢复良好5例(25.00%),中残4例(20.00%),重残2例(10.00%),植物生存2例(10.00%),死亡7例(35.00%);对照组患者恢复良好1例(5.00%),中残2例(10.00%),重残2例(10.00%),植物生存3例(15.00%),死亡12例(60.00%)。两组患者的预后情况比较,差异无统计学意义(P>0.05)。结论3D打印导航下脑干血肿穿刺外引流术治疗脑干出血,较常规的治疗手段相比,具有手术后创伤少,时间短,能明显提高穿刺成功率及准确率,降低死亡率等优点,值得基层医院大力推广。

Objective To discuss the clinical effect of hematoma puncture and external drainage under 3D printing navigation in the treatment of brainstem hemorrhage.Methods A total of 40 patients with brainstem hemorrhage were divided into research group and control group according to different treatment methods,with 20 cases in each group.The research group underwent hematoma puncture and external drainage under 3D printing navigation,while the control group underwent conventional simple minimally invasive puncture.The postoperative drainage time,hospital stay,National Institutes of Health stroke scale(NIHSS)score before discharge,and the prognosis within 6 months of follow-up were compared between the two groups.Results In the research group,the postoperative drainage time(1.53±0.63)d and hospital stay(13.05±1.66)d were shorter than(3.18±0.75)and(18.65±2.18)d in the control group;the NIHSS score(9.25±1.53)points before discharge was lower than(12.66±2.01)points in the control group;all the differences were statistically significant(P<0.05).At 6 months follow-up,5 cases(25.00%)recovered well,4 cases(20.00%)had moderate disability,2 cases(10.00%)had severe disability,2 cases(10.00%)survived vegetatively and 7 cases(35.00%)died in the research group;1 case(5.00%)recovered well,2 cases(10.00%)had moderate disability,2 cases(10.00%)had severe disability,3 cases(15.00%)survived vegetatively,and 12 cases(60.00%)died in the control group.There was no statistically significant difference in the prognosis of the two groups(P>0.05).Conclusion Compared with conventional treatment methods,hematoma puncture and external drainage under 3D printing navigation has the advantages of less trauma and short hospital stay after surgery,and can significantly improve the success rate and accuracy of puncture,and reduce the mortality.It is worthy to be popularized by grass-roots hospitals.