Rosa定位钻孔血肿清除术与经验性定位颅骨钻孔血肿清除术治疗自发性脑出血的疗效对比分析

Comparative analysis of the effects of ROSA localized burr hole hematoma removal and empirical localized burr hole hematoma removal in the treatment of spontaneous intracerebral hemorrhage

目的观察立体定向手术机器人(Rosa)定位钻孔血肿清除术与经验性定位颅骨钻孔血肿清除术治疗自发性脑出血(SICH)的临床疗效。方法选取2017年2月至2019年1月于国药葛洲坝中心医院神经外科就诊的SICH患者100例,按照患者自愿且非随机对照原则分为2组,观察组41例,对照组59例。观察组患者行Rosa定位钻孔血肿清除术,对照组患者行小骨窗血肿清除术治疗,记录2组患者手术相关指标,比较近、远期疗效及术后并发症发生情况。结果与对照组相比,观察组患者手术时间、血肿清除时间、术后住院时间均显著缩短,术后并发症发生率显著降低,差异均有统计学意义(P<0.05);术后1个月,观察组患者治疗有效率高于对照组,差异有统计学意义(P<0.05);术后6个月,2组患者预后良好率比较,差异均无统计学意义(P>0.05)。结论Rosa定位钻孔血肿清除术与小骨窗血肿清除术治疗SICH远期疗效相当,但前者近期疗效更优,术后恢复快,并发症风险更低,具有安全、高效、精准的特点。

Objective To observe the clinical effects of Robot System Assistant(Rosa)localized burr hole hematoma removal and empirical localized burr hole hematoma removal in the treatment of spontaneous intracerebral hemorrhage(SICH).Methods A total of 100 patients with SICH who were admitted to Neurosurgery Department of Gezhouba Central Hospital of Sinopharm between February 2017 and January 2019 were selected as the subjects.They were divided into the observation group(41 cases)and the control group(59 cases)according to the voluntary and non-randomized control principle.Patients in the observation group were treated with Rosa localized burr hole hematoma removal,and those in the control group were treated with empirical localized burr hole hematoma removal.Surgery related indicators of the two groups were recorded.The short-term and long-term curative effects and the occurrence of postoperative complications were compared between the two groups.Results Compared with the control group,the operation time,hematoma removal time and postoperative hospital stay in the observation group were significantly shorter,the incidence rate of postoperative complications in the observation group was significantly reduced(P<0.05).At 1 month after surgery,the effective rate of treatment in the observation group was higher than that in the control group(P<0.05).There was no statistically significant difference in the good prognosis rate between the two groups at 6 months after surgery(P>0.05).Conclusion Rosa localized burr hole hematoma removal has the same long-term effect as empirical localized burr hole hematoma removal in the treatment of SICH.However,the former can achieve better short-term effect,faster postoperative recovery and lower risk of complications,with characteristics of safety,efficiency and accuracy.