3D-Slicer结合神经内镜与显微手术治疗基底节区高血压脑出血的疗效对比研究  

Compartive study on the clinical efficacy of 3D-Slicer Software combined with neuroendoscopy or microsurgery in the treatment of hypertensive intracerebral hemorrhage in Basal Nuclei Zone

作　　者：黄伟[1] 郭凤 冯波[1] 唐智勇 李国强[1] 孙立鹏[1] 李荣伟 HUANG Wei;GUO Feng;FENG Bo(Department of Neurosurgery,Hanzhong Central Hospital of Shanxi Province,Hanzhong 723000,China)

机构地区：[1]陕西省汉中市中心医院神经外科,723000 [2]陕西省汉中市中心医院妇科,723000 [3]贵阳市第二人民医院神经外科

出　　处：《临床外科杂志》2018年第7期494-496,共3页Journal of Clinical Surgery

摘　　要：目的探讨3D-Slicer结合神经内镜与显微手术两种手术方式治疗基底节区高血压脑出血的临床疗效。方法 60例基底节区高血压脑出血患者,按随机数字表法分为显微手术组(n=30)和神经内镜组(n=30)。显微手术组采用骨瓣开颅显微镜下血肿清除术,神经内镜组在3D-Slicer软件及神经内镜辅助下行血肿清除术。对比两组患者的围手术期指标,临床疗效及预后情况。结果神经内镜组的手术时间、术中出血量、血肿残留量及住院时间均显著少于显微手术组,而血肿清除率显著高于显微手术组,差异均有统计学意义(P<0.05)。治疗后两组患者的美国国立卫生研究院卒中量表(NIHSS)评分均显著降低,且神经内镜组明显优于显微手术组,差异均有统计学意义(P<0.05)。术后个6月随访神经内镜组的预后良好率为60.0%,显著高于显微手术组的26.7%,差异有统计学意义(P<0.05)。结论 3D-Slicer结合神经内镜治疗基底节区高血压脑出血的临床疗效更为显著,且能改善患者的预后情况,值得推广使用。Objective To analyze the clinical effcacy of 3 D-Slicer software combine with neuroendoscopy and microsurgery in the treatment of hypertensive intracerebral hemorrhage in Basal Nuclei Zone. Methods 60 patients with hypertensive intracerebral hemorrhage in Basal Nuclei Zone were divided into microsurgery group and neuroendoscopy group according to the random number table,30 cases of each group. The microsurgery group were treated with undergoing conventional craniotomy,and the neuroendoscopic group were treated with 3 D-Slicer combine with neuroendoscopic. The perioperative indicators,clinical efficacy,and prognosis were compared between the two groups. Results The operation time,bleeding volum,residual rhematoma,and hospitalization time of the neuroendoscopic group were significantly shorter than the microsurgery group,and the hematoma clearance rate of the neuroendoscopic group was significantly higher than the microsurgery group,the differences were statistically significant（ P〈0. 05）. After the treatment,the National Institute of Health Stroke Scale（ NIHSS） of the two groups were significantly decreased,and the neuroendoscopic group was significantly better than the microsurgery group,the differences were statistically significant（ P〈0. 05）. In the six months follow-up,the rate of favorable prognosis in neuroendoscopic group was 60. 0%,which was significantly better than microsurgery group（26. 7%）,the difference was statistically significant（ P〈0. 05）. Conclusion 3 D-Slicer software combined with neuroendoscopic in the treatment of hypertensive intracerebral hemorrhage in Basal Nuclei Zone has a significant curative effect,can improve the prognosis. It is worthy of clinical promotion.

关 键 词：3D-Slicer 神经内镜 显微手术 高血压脑出血 

分 类 号：R651.1[医药卫生—外科学]