3D-slicer联合智能手机辅助定位下神经内镜血肿清除术治疗高血压性基底节区脑出血的临床疗效分析

Clinical Analysis of 3D-slicer Combined with Smartphone-assisted Neuroendoscopic Hematoma Evacuation for Hypertensive Intracerebral Hemorrhage in Basal Ganglia

目的分析将3D-slicer联合智能手机辅助定位下神经内镜血肿清除术应用于高血压性基底节区脑出血的手术价值。方法随机选取2020年1月—2024年1月晋江市医院(上海市第六人民医院福建医院)神经外科收治的100例高血压性基底节区脑出血患者为研究对象,根据手术方法分为对照组和研究组,各50例,对照组实施小骨窗开颅脑内血肿清除术治疗,研究组实施3D-slicer+智能手机辅助定位下神经内镜血肿清除术治疗。分析两组手术效果、神经功能、预后效果、脑微循环指标及并发症。结果研究组手术时间短于对照组,术中出血量少于对照组,血肿清除率高于对照组,差异有统计学意义(P均<0.05)。研究组神经功能缺损量表评分、格拉斯哥昏迷量表评分及Warlow修订量表评分优于对照组,差异有统计学意义(P均<0.05)。研究组血小板计数和纤维蛋白原水平低于对照组,差异有统计学意义(P均<0.05)。研究组并发症发生率为6.00%(3/50),低于对照组的20.00%(10/50),差异有统计学意义(χ^(2)=4.332,P<0.05)。结论将3D-slicer联合智能手机辅助定位下神经内镜血肿清除术应用于高血压性基底节区脑出血治疗中,有术时短、出血少,血肿清除率高的优势,利于脑微循环的有效灌注和并发症率降低,能显著提高远期预后。

Objective To analyze the value of 3D-slicer combined with smartphone-assisted neuroendoscopic hema-toma evacuation in hypertensive basal ganglia hemorrhage.Methods A total of 100 patients with hypertensive intrace-rebral hemorrhage in basal ganglia treated by neurosurgery in Jinjiang Hospital(Fujian Hospital of Shanghai Sixth People's Hospital)from January 2020 to January 2024 were randomly selected as the research objects.According to the surgical methods,they were divided into control group and study group,with 50 cases in each group.The control group was treated with small bone window craniotomy for intracerebral hematoma removal,and the study group was treated with 3D-slice+smartphone-assisted neuroendoscopic hematoma removal.The operation effect,neurological function,prognosis,brain microcirculation index and complications of the two groups were analyzed.Results The length of surgery in the study group was longer than that in the control group,the intraoperative blood loss was less than that of the control group,and the hematoma clearance rate was higher than that of the control group,the differ-ences were statistically significant(all P<0.05).The neurological deficit score,Glasgow Coma Scale and Warlow Revi-sion Scale score were better than the control group,the differences were statistically significant(all P<0.05).The plate-let count and fibrinogen level in the study group were lower than that of the control group,the differences were statisti-cally significant(both P<0.05).The complication rate in the study group was 6.00%(3/50),lower than 20.00%(10/50)in the control group,the difference was statistically significan(χ^(2)=4.332,P<0.05).Conclusion The application of 3D-slicer combined with smartphone-assisted neuroendoscopic hematoma evacuation in the treatment of hypertensive basal ganglia intracerebral hemorrhage has the advantages of short operation time,less bleeding and high hematoma clearance rate,the effective perfusion of cerebral microcirculation and the reduction of complication rate can signifi-cantly improve the long-term prognosis.