3D slicer软件辅助神经内镜微创手术治疗高血压脑出血的临床效果  

Clinical effect of 3D slicer software assisted minimally invasive endoscopic neuroendoscopic surgery on treating hypertensive intracerebral hemorrhage

作　　者：易剑波 范学政 黄进能[2] 李亚平[2] 

机构地区：[1]深圳市光明新区人民医院神经外科,广东深圳518106 [2]广西中医药大学附属瑞康医院神经外科,广西南宁530001

出　　处：《中国当代医药》2018年第4期4-7,共4页China Modern Medicine

基　　金：国家"十二五"科技支撑计划项目(2011BAI08B05)

摘　　要：目的探讨3D slicer软件辅助神经内镜微创手术治疗高血压脑出血的方法及临床效果。方法选取2016年8月~2017年6月深圳市光明新区人民医院收治的30例基底节区高血压脑出血患者作为研究对象,按照治疗方法的不同分为分为内镜手术组和开颅手术组,各15例。内镜手术组术前采用3D slicer软件对血肿三维重建及模拟手术入路,指导神经内镜清除血肿。开颅手术组采用显微镜下常规骨瓣开颅血肿清除手术治疗。比较两组手术患者的血肿清除率、手术时间及m RS评分。结果内镜手术组的血肿清除率为(91.5±5.5)%,高于开颅手术组的(85.3±6.8)%;手术时间为(1.6±0.6)h,短于开颅手术组的(4.8±1.4)h,差异有统计学意义(P<0.05)。内镜手术组术后3个月的m RS评分为(3.3±1.4)分,低于开颅手术组的(4.3±1.7)分,差异有统计学意义(P<0.05)。结论应用3D slicer软件辅助神经内镜微创手术治疗高血压脑出血可提高血肿清除率,手术入路更加精准能够缩短手术时间,患者临床预后情况优于开颅显微镜下血肿清除手术治疗。Objective To explore the methods and clinical effects of 3D slicer software assisted minimally invasive surgery in the treatment of hypertensive intracerebral hemorrhage.Methods From August 2016 to June 2017,30 hypertensive patients with cerebral hemorrhage in basal ganglia region in our hospital were selected and divided into the en- doscopic surgery group and the craniotomy group according to different therapeutic methods,15 cases in each group.The endoscopic surgery group was treated with 3D slicer software for three-dimensional reconstruction of hematoma and- simulation of surgical approach guiding endoscopic removal of hematoma.In the craniotomy group,conventional bone flap craniotomy for hematoma clearance under the microscope was adopted.The hematoma clearance rate,operation time and mRS score of the two groups were compared.Results The hematoma clearance rate in the endoscopic surgery group was （91.5±5.5）%,which was higher than that in the craniotomy group （[85.3±6.8]%）,with significant difference （P〈0.05）. The operation time in the endoscopic surgery group was （1.6±0.6）h,which was shorter than that in the craniotomy group （4.8±1.4）h,with significant difference （P〈0.05）.Three months after surgery,the mRS score in the endoscopic surgery group was （3.3±1.4） points,which was lower than that of the craniotomy group （[4.3±1.7] points）,with significant difference （P〈0.05）.Conelusion Application of 3D slicer software to assist neuroendoscopic minimal-invasion surgery in the treatment of hypertensive intracerebral hemorrhage can improve hematoma clearance rate,shorten operation time by precise surgical approach.The prognosis of patients in the endoscopic surgery is superior to that by craniotomy for hematoma clearance under the microscope.

关 键 词：脑出血 高血压 神经内镜 3D slicer 手术 

分 类 号：R743.34[医药卫生—神经病学与精神病学]