3D打印导板辅助穿刺引流术治疗脑出血临床观察

Clinical observation of 3D printing guide plate assisted puncture drainage in the treatment of cerebral hemorrhage

目的探讨3D打印导板辅助穿刺引流术治疗20 mL左右脑出血患者的临床疗效。方法将105例脑出血患者随机分为对照组和观察组,实施常规保守治疗的53例分为对照组,实施3D打印导板辅助穿刺引流术治疗的53例分为观察组。比较2组血肿清除率、神经功能[美国国立卫生研究院卒中量表(NIHSS)评分]、认知功能[简易智力状态检查量表(MMSE)评分]及肢体功能[Fugl-Meyer运动功能量表(FMA)评分],并记录2组治疗期间并发症情况。结果观察组治疗后1 d、3 d及10 d的血肿清除率分别为(78.45±5.06)%、(80.73±5.29)%及(82.68±5.17)%,高于对照组的(32.16±4.12)%、(36.47±4.38)%、(42.67±4.78)%(P<0.05),观察组住院时间短于对照组(P<0.05)。治疗后,观察组NIHSS评分为(13.17±1.82)分,显著低于对照组的(18.64±2.71)分(P<0.05),MMSE评分和FMA总评分显著高于对照组[(28.67±1.24)分比(26.25±2.62)分,(77.03±10.13)分比(65.50±8.89)分](P<0.05)。观察组总并发症发生率为5.76%,低于对照组的18.87%(P<0.05)。结论相对于保守治疗,3D打印导板辅助穿刺引流术治疗20 mL左右脑出血患者疗效确切,可显著提升患者血脂清除率,改善患者认知功能和肢体功能,且能降低脑出血总并发症发生率。

Objective To investigate the clinical efficacy of 3D printing guide plate assisted puncture and drainage in the treatment of patients with cerebral hemorrhage about 20 mL.Methods Totally 105 patients with cerebral hemorrhage were randomly divided into control group and observation group,53 patients who received routine conservative treatment were divided into control group,and 53 patients who received 3D printing guide plate assisted puncture drainage were divided into observation group.The hematoma clearance rate,neurological function(National Institutes of Health stroke scale(NIHSS)),cognitive function(mini-mental state examination scale(MMSE))and limb function(Fugl-Meyer assessment scale(FMA))were compared between the two groups,and the complications during treatment were recorded.Results The hematoma clearance rates at 1 d,3 d and 10 d after treatment in the observation group were(78.45±5.06)%,(80.73±5.29)%and(82.68±5.17)%,respectively,which were higher than(32.16±4.12)%,(36.47±4.38)%and(42.67±4.78)%in the control group(P<0.05).The hospitalization time in the observation group was shorter than that in the control group(P<0.05).After treatment,the NIHSS score of the observation group was(13.17±1.82)points,which was significantly lower than that of the control group((18.64±2.71)points,P<0.05),and the MMSE score and FMA score were significantly higher than those of the control group((28.67±1.24)points vs(26.25±2.62)points,(77.03±10.13)points vs(65.50±8.89)points)(P<0.05).The total incidence of complications in the observation group was 5.76%,which was lower than 18.87%in the control group(P<0.05).Conclusion Compared with conservative treatment,3D printing guide plate assisted puncture drainage is effective in the treatment of patients with cerebral hemorrhage of about 20 mL,which can significantly improve the blood lipid clearance rate,improve the cognitive function and limb function of patients,and reduce the incidence of total complications of cerebral hemorrhage.