双坐标系虚拟穿刺定位在自发性脑干出血微创治疗中的应用  

Application of Two-coordinate System Virtual Puncture Localization in the Minimally Invasive Treatment of Spontaneous Brainstem Hemorrhage

作　　者：赵端允 李进军 朱明启[1] 李光宏[1] 王洪波[1] ZHAO Duanyun;LI Jinjun;ZHU Mingqi;LI Guanghong;WANG Hongbo(Department of Neurosurgery,Heze Municipal Hospital,Heze,Shandong Province,274000 China)

机构地区：[1]菏泽市立医院神经外科,山东菏泽274000

出　　处：《世界复合医学》2022年第11期20-24,共5页World Journal of Complex Medicine

摘　　要：目的探讨双坐标系虚拟穿刺定位技术在自发性脑干出血微创治疗中的应用价值。方法选取于2019年4月—2021年6月在菏泽市立医院治疗的自发性脑干出血患者36例,分为手术组和保守组,其中手术组17例,应用双坐标系虚拟穿刺定位技术微创软通道穿刺治疗,保守组19例,应用药物等非手术方式治疗,对比两组治疗结果,并进一步分析手术组不同血肿类型的预后。结果手术组所有患者均一次穿刺成功,发病后30 d生存率82.4%,保守治疗组生存率47.4%,手术组优于保守组,差异有统计学意义(P=0.041)。手术组生存患者改良mRS评分(3.3±1.0)分;保守组生存患者改良mRS评分(4.3±0.7)分,手术组优于保守组,差异有统计学意义(P<0.05)。手术组中单侧被盖型发病后30 d生存率为100%,生存患者改良mRS评分为(2.6±0.5)分,均为最优,巨大型最差,生存率为0%,单侧被盖型与巨大型组间差异有统计学意义(P<0.05)。结论双坐标系虚拟穿刺定位技术在自发性脑干出血微创治疗中应用效果理想,其中单侧被盖型血肿术后预后最好,巨大型预后最差。Objective To explore the application value of dual coordinate system virtual puncture localization technique in the minimally invasive treatment of spontaneous brainstem hemorrhage.Methods Thirty-six patients with spontaneous brainstem hemorrhage treated in Heze Municipal Hospital from April 2019 to June 2021 were selected and divided into surgical group and conservative group.17 cases in the surgical group were treated with minimally invasive soft channel puncture using the dual coordinate system virtual puncture positioning technique,and 19 cases in the conservative group were treated with non-surgical modalities such as drugs.The results of the two groups were compared,and the prognosis of different hematoma types in the surgical group was further analyzed.Results All patients in the surgical group had a successful puncture and a survival rate of 82.4%at 30 d after onset,compared with 47.4%in the conservative group,which was statistically superior to the conservative group,and the difference was statistically significant(P=0.041).The modified mRS score was(3.3±1.0)points of the surviving patients in the surgical group.In the conservative group,the modified mRS score of survival patients was(4.3±0.7)points,and the surgical group was better than the conservative group,and the difference was statistically significant(P<0.05).The survival rate at 30 d after onset was 100%in the surgical group for the unilateral covered type,and the modified mRS score was(2.6±0.5)points for the surviving patients,both of which were optimal,and the worst for the giant type,with a survival rate of 0%,with a statistically significant difference between the unilateral covered and giant groups(P<0.05).Conclusion The two-coordinate system virtual puncture localization technique is ideal in the minimally invasive treatment of spontaneous brainstem hemorrhage,in which the unilateral covered type hematoma has the best postoperative prognosis and the giant type has the worst prognosis.

关 键 词：脑干出血 自发性 微创手术 手术定位 血肿分型 治疗 

分 类 号：R4[医药卫生—临床医学]