神经导航结合3D重建技术引导神经内镜血肿清除术在高血压性脑出血患者中的应用

Application of neuro-navigation combined with 3D reconstruction technology-guided neuroendoscopic hematoma evacuation in hypertensive intracerebral hemorrhage patients

目的探讨神经导航结合3D重建技术引导神经内镜血肿清除术在高血压性脑出血患者中的应用。方法选取2016年1月至2019年1月南京中医药大学附属沭阳医院入住的高血压性脑出血患者110例,按照治疗手段不同分为对照组(普通内镜治疗)58例和观察组(神经导航结合3D重建技术引导神经内镜治疗)52例。对比两组患者在手术效果、术后并发症及预后等方面的差异。结果与对照组相比,观察组患者的手术时间明显缩短,术中出血量明显减少,血肿清除率明显提高,且差异均有统计学意义(t=3.130、3.032、17.592,P<0.05)。与对照组相比,观察组患者出现消化道出血、肺部感染、颅内再次出血、电解质紊乱及颅内感染的比例较小,且消化道出血者及颅内再次出血者差异有统计学意义(χ^(2)=3.993、5.568,P<0.05)。术后随访半年,两组患者预后改良Rankin量表分级差异无统计学意义(χ^(2)=0.201,P>0.05)。结论神经导航结合3D重建技术引导神经内镜血肿清除术可显著提高高血压性脑出血患者的手术效果,减少并发症的发生,值得临床上推广应用。

Objective To explore the application of neuro-navigation combined with 3D reconstruction technology-guided neuroendoscopic hematoma evacuation in hypertensive intracerebral hemorrhage patients.Methods A total of 110 hypertensive intracerebral hemorrhage patients admitted to Shuyang Hospital Affiliated to Nanjing University of Traditional Chinese Medicine from January 2016 to January 2019 were divided into the control group(treated with conventional endoscopy,n=58)and the observation group(treated with neuro-navigation combined with 3D reconstruction technologyguided endoscopy,n=52).The differences in surgical efficacy,postoperative complications,and prognosis between the two groups were compared.Results Compared with the control group,the observation group had significant shorter operation time,significant reduced intraoperative bleeding volume and significant higher hematoma evacuation rate,all the differences were statistically significant(t=3.130,3.032,17.592;P<0.05).Compared with the control group,the proportion of cases with gastrointestinal bleeding,pulmonary infection,intracranial re-bleeding,electrolyte disorders and intracranial infection in the observation group was smaller,and the differences in patients with gastrointestinal bleeding and intracranial re-bleeding were statistically significant(χ^(2)=3.993,5.568;P<0.05).There was no statistically significant difference in the modified Rankin Scale score between the two groups after 6 months of follow-up(χ^(2)=0.201,P>0.05).Conclusion Neuro-navigation combined with 3D reconstruction technology-guided neuroendoscopic hematoma evacuation can significantly improve the surgical efficacy of hypertensive intracerebral hemorrhage patients,reduce the incidence of complications,and is worthy of clinical promotion.