摘要
目的探讨机器人辅助下立体定向微创穿刺抽吸及引流术治疗高血压脑出血(HICH)的临床疗效。方法回顾性分析安徽省第二人民医院神经外科自2019年10月至2022年2月收治的33例HICH患者,其中10例采用机器人辅助下立体定向微创穿刺抽吸及引流术治疗(机器人组),12例采用CT辅助定位微创穿刺抽吸及引流术治疗(CT定位组),另11例行常规药物保守治疗(对照组),比较手术组的手术时长、血肿清除率、使用尿激酶次数、引流管留置时间,比较3组患者治疗期间肺部感染率、NICU住院时间、甘露醇使用时间、72 h脑水肿体积以及入院即刻和术后1、3、5、7、14 d的美国国立卫生研究院卒中量表(NIHSS)评分情况。结果与对照组比较,手术组治疗期间肺部感染率降低、NICU住院时间减少、甘露醇使用时间缩短、72 h脑水肿面积减小、不同时间的NIHSS评分明显改善,差异均具有统计学意义(P<0.05);与CT定位组比较,机器人组血肿清除率提高,使用尿激酶次数减少,引流管留置时间缩短,肺部感染率降低,NICU住院时间减少,甘露醇使用时间缩短,72 h脑水肿体积减小,不同时间的NIHSS评分明显改善,差异均具有统计学意义(P<0.05)。结论机器人辅助下立体定向微创穿刺抽吸及引流术治疗HICH能更彻底清除血肿、减少术后并发症,更有助于提高患者术后神经功能恢复。
ObjectiveTo investigate the clinical effect of robot-assisted stereotactic minimally invasive aspiration and drainage in the treatment of hypertensive intracerebral hemorrhage(HICH).MethodsRetrospective analysis was performed on 33 eligible patients with HICH admitted to Neurosurgery Department of Anhui No.2 Provincial People’s Hospital from October 2019 to February 2022.Among them,10 cases were treated with robot-assisted stereotactic minimally invasive aspiration and drainage(robot group),12 cases were treated with CT-assisted minimally invasive puncture aspiration and drainage(CT positioning group),and the other 11 cases were treated with conventional conservative medicine(control group).The operative duration,hematoma clearance rate,times of the use of urokinase,and indwelling time of drainage tube in the operation group were compared.During treatment,the pulmonary infection rate,NICU hospitalization time,the length of using mannitol,72 h brain edema volume and the National Institutes of Health stroke scale(NIHSS)score immediately after admission,1st,3rd,5th,7thand 14thdays after surgery in 3 groups were compared.ResultsCompared with the control group,the surgical group has a decreased infection rate,NICU hospitalization time,shorter mannitol use time,reduced 72 h cerebral edema area and NIHSS score at different time were significantly improved,the differences were statistically significant(allP<0.05).Compared with the CT localization group,the robot group had higher hematoma clearance rate,fewer times of use of urokinase,shorter indwelling time of drainage tube,lower pulmonary infection rate,less NICU hospitalization time,shorter mannitol use time,reduced 72 h cerebral edema area,and significantly improved NIHSS score at different time(allP<0.05).ConclusionRobot-assisted stereotactic minimally invasive aspiration and drainage in the treatment of HICH can remove hematoma more thoroughly,reduce postoperative complications,and is more conducive to improve postoperative neurological recovery of patients.
作者
许少年
张永明
黄振山
丁俊
姜国伟
钱峰
张连富
Xu Shaonian;Zhang Yongming;Huang Zhenshan;Ding Jun;Jiang Guowei;Qian Feng;Zhang Lianfu(Department of Neurosurgery,Anhui No.2 Provincial People’s Hospital,Hefei 230041,China)
出处
《中华神经创伤外科电子杂志》
2022年第2期76-80,共5页
Chinese Journal Of Neurotraumatic Surgery：Electronic Edition
基金
安徽省高校自然重点科研项目(KJ2020A0851)
关键词
高血压脑出血
机器人
立体定向
微创
穿刺
Hypertensive intracerebral hemorrhage
Robot
Stereotactic
Minimally invasive
Puncture
作者简介
通信作者:张永明,Email:zymhf2966@163.com
