增强现实技术辅助神经内镜与小骨窗开颅血肿清除术治疗高血压脑出血疗效分析

Comparision of curative effect of augmented reality assisted neuroendosope and small bone window craniotomy for hypertensive cerebral hemorrhage

目的 比较增强现实技术辅助神经内镜血肿清除术与小骨窗开颅血肿清除术治疗高血压脑出血的疗效。方法 选择2016年7月至2017年12月行小骨窗开颅血肿清除术(41例)或增强现实技术辅助神经内镜血肿清除术(41例)的高血压脑出血患者共82例,记录手术时间、术中出血量、血肿清除率和住院时间,以及术后再出血、颅内感染、肺部感染、消化道出血等并发症发生率,Glasgow预后分级(GOS)评价患者预后。结果 与小骨窗开颅组相比,神经内镜组患者手术时间[(72.66±5.21)min对(137.51±6.25)min;t=-51.065,P=0.000]和住院时间[(12.21±1.81)d对(13.12±1.41)d;t=-4.035,P=0.035]缩短,术中出血量减少[(91.88±8.89)ml对(400.24±36.57)ml;t=-52.464,P=0.000],血肿清除率增加[(98.29±1.37)%对(72.83±9.37)%;t=-17.224,P=0.002];术后6个月时预后更佳(Z=-3.303,P=0.001);两组并发症发生率差异无统计学意义[12.20%(5/41)对26.83%(11/41);χ~2=2.795,P=0.095]。结论 增强现实技术辅助神经内镜血肿清除术治疗高血压脑出血的疗效优于小骨窗开颅血肿清除术。

Objective To compare the efficacy of augmented reality assisted neuroendoscope of evacuation of hematoma and small bone window craniotomy in the treatment of hypertensive cerebral hemorrhage.Methods From July 2016 to December 2017,82 patients with hypertensive cerebral hemorrhage were treated with small bone window craniotomy(41 cases)or augmented reality assisted neuroendoscopic surgery(41 cases)of evacuation of hematoma.The operation time,intraoperative blood loss.,hematomas clearance rate and hospitalization time,as well as the incidence of postoperative rebleeding,intracranial infection,pulmonary infection,gastrointestinal bleeding and other complications,and Glasgow Outcome Scale(GOS)were recorded to evaluate prognosis of the 2 groups.Results Compared with the small bone window craniotomy group,in the neuroendoscopic group,the operation time[(72.66 t±5.21)min vs.(137.51 t±6.25)min;t =-51.065,P = 0.000],the hospitalization time[(12.21 ± 1.81)d vs.(13.12 ± 1.41)d;t=-4.035,P = 0.035]shortened,intraoperative blood loss decreased[(91.88 ± 8.89)ml vs.(400.24 ± 36.57)ml;t=-52.464,P = 0.000],hematoma clearance rate increased[(98.29 ± 1.37)% vs.(72.83 ± 9.37)%;t =-17.224,P = 0.002],and prognosis was better at 6 months after operation(Z=-3.303,P = 0.001).The complication rate was no significant difference between the 2 groups[12.20%(5/41)vs.26.83%(11/41);χ~2 = 2.795,P = 0.095].Conclusions Augmented reality assisted neuroendoscope of evacuation of hematoma is superior than small bone window craniotomy.