影像后处理结合3D打印手术导板辅助微创穿刺术治疗自发性脑出血的临床研究  

Treatment of spontaneous intracerebral hemorrhage by minimally invasive puncture assisted by image post-processing combined with 3D printing surgical guide plate

作　　者：秦虎[1] 马木提江·木尔提扎 王昀[1] 吴鹏飞[1] 王增亮[1] 汪永新[1] Qin Hu;Mamutijiang Multiza;Wang Yun;Wu Pengfei;Wang Zengliang;Wang Yongxin(Department of Neurosurgery,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学第一附属医院神经外科,乌鲁木齐830000

出　　处：《中华神经医学杂志》2022年第12期1250-1254,共5页Chinese Journal of Neuromedicine

基　　金：新疆维吾尔自治区区域协同创新专项(2021E01013)。

摘　　要：目的:探讨影像后处理结合3D打印手术导板辅助微创穿刺术治疗自发性脑出血的临床疗效。方法:回顾性收集新疆医科大学第一附属医院神经外科自2019年1月至2022年1月采用微创穿刺术治疗的76例自发性脑出血患者的临床资料,根据手术辅助方式的不同,将患者分为依据影像学定位辅助的对照组(43例)与应用影像后处理结合3D打印手术导板辅助的观察组(33例)。比较2组患者术后临床疗效的差异,指标包括一次性穿刺成功率、穿刺精准率、术后第3天血肿清除率、术后并发症情况、术后3个月预后情况等。结果:观察组患者的一次性穿刺成功率(100.0%)、穿刺精准率(90.9%)、术后第3天有效血肿清除率(93.9%)、术后3个月预后良好率(84.8%)均明显高于对照组(83.7%、72.1%、76.7%、62.8%),差异均有统计学意义(P<0.05)。2组患者术后穿刺道出血(6.1%vs.9.3%)、颅内感染(9.1%vs.11.6%)比例差异均无统计学意义(P>0.05)。结论:影像后处理结合3D打印手术导板辅助微创穿刺术治疗自发性脑出血能够更精准地进行血肿穿刺,临床疗效更优于传统方式,且能使微创穿刺术尽可能达到治疗均质化。Objective To explore the clinical efficacy of spontaneous intracerebral hemorrhage treated by minimally invasive puncture assisted by image post-processing combined with 3D printing surgical guide plate.Methods The clinical data of 76 patients with spontaneous intracerebral hemorrhage admitted to Department of Neurosurgery,First Affiliated Hospital of Xinjiang Medical University from January 2019 to January 2022 were retrospectively analyzed.According to different guiding ways at minimally invasive puncture,they were divided into a control group guided by imaging positioning(n=43)and an observation group guided by image post-processing combined with 3D printing surgical guide plate(n=33).The differences of postoperative clinical efficacies were compared between the two groups,including one-time puncture success rate,puncture accuracy rate,hematoma clearance rate on 3rd d of surgery,postoperative complications,and prognoses 3 months after surgery.Results Patients in the observation group had significantly higher success rate of one-time puncture(100.0%vs.83.7%),puncture accuracy(90.9%vs.72.1%),effective hematoma clearance on the 3rd d of surgery(93.9%vs.76.7%),good prognosis rate 3 month after surgery(84.8%vs.62.8%)than those of the control group(P<0.05).There was no significant difference in postoperative intracranial infection(9.1%vs.11.6%)or puncture path bleeding rate(6.1%vs.9.3%)between the two groups(P>0.05).Conclusion minimally invasive puncture assisted by image post-processing and 3D printed surgical guide plate can more accurately puncture hematoma in the treatment of spontaneous intracerebral hemorrhage,and its clinical efficacy is more satisfactory than the convention one;moreover,minimally invasive puncture can help to achieve treatment homogenization.

关 键 词：自发性脑出血 微创穿刺术 影像后处理 3D打印手术导板 

分 类 号：R651.1[医药卫生—外科学]