基于计算机3D-Slicer软件系统实施微创穿刺置管术治疗高血压脑出血的临床效果探讨  

Clinical effect of minimally invasive catheterization based on computer 3D-Slicer software system in the treatment of hypertensive intracerebral hemorrhage

作　　者：杨家应 王蕾 高宗[2] Yang Jiaying;Wang Lei;Gao Zong(Department of Neurosurgery,People′s Hospital of Lanling County in Shandong,Linyi 277700,China;Department of Neurosurgery,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Ji′nan 250014,China)

机构地区：[1]兰陵县人民医院神经外科,临沂277700 [2]山东中医药大学附属医院神经外科,济南250014

出　　处：《中国医师进修杂志》2023年第2期167-171,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的:探讨基于计算机3D-Slicer软件系统实施微创穿刺置管术治疗高血压脑出血(HICH)的临床效果。方法:选取2019年6月至2020年6月兰陵县人民医院收治的350例HICH患者作为研究对象,根据手术方法分为3D-Slicer组(175)和CT组(175例),分别采用3D-Slicer软件系统辅助下微创穿刺置管术及CT定位下血肿微创软通道穿刺引流术,比较两组手术一般情况、血肿清除率、实验室指标、氧化应激指标及预后。结果:3D-Slicer组术中出血量、住院时间少于CT组[(81.42±12.33)ml比(101.54±11.71)ml、(15.67±3.71)d比(17.22±3.52)d],一次性成功穿刺至预设位置成功率高于CT组[100.00%(175/175)比81.14%(142/175)],差异有统计学意义(χ^(2)=34.26,P<0.05)。3D-Slicer组术后1、3、7 d的血肿清除率均高于CT组[(87.93±8.54)%比(66.43±7.99)%、(92.48±10.31)%比(89.52±11.74)%、(96.37±10.22)%比(94.30±9.25)%],差异有统计学意义(P<0.05)。术后7 d,3D-Slicer组谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)、过氧化氢酶(CAT)水平高于CT组[(121.36±10.59)U/L比(109.14±9.05)U/L、(92.80±8.63)μg/L比(81.45±9.11)μg/L、(24.64±5.43)U/L比(20.84±3.47)U/L],MDA水平低于CT组[(4.42±0.57)μmol/L比(5.19±0.51)μmol/L],差异有统计学意义(P<0.05)。术后3个月,3D-Slicer组预后良好率高于CT组[73.71%(129/175)比62.29%(199/175)],差异有统计学意义(χ^(2)=5.25,P<0.05)。结论:采用基于计算机3D-Slicer软件系统实施微创穿刺置管术治疗HICH,能够在提高临床疗效的同时,缩短患者住院时间,减少术中出血量,改善预后。Objective To investigate the clinical effect of minimally invasive catheterization based on computer 3D-Slicer software system in the treatment of hypertensive intracerebral hemorrhage(HICH).Methods Three hundred and fifty patients with HICH treated in People′s Hospital of Lanling County in Shandongfrom June 2019 to June 2020 were selected as the research object.According to the operation method,they were divided into 3D-Slicer group(175 cases)and CT group(175 cases).They were treated with 3D-Slicer software-assisted minimally invasive catheterization and minimally invasive soft-channel drainage under CT localization,respectively.The general conditions of the surgery,hematoma clearance rate and laboratory indexes,oxidative stress index and prognosis were compared between the two groups.Results The intraoperative blood loss,the hospitalizationtimein the 3D-Slicer group were lower than those in the CT group:(81.42±12.33)ml vs.(101.54±11.71)ml,(15.67±3.71)d vs.(17.22±3.52)d;the success rate of one-time successful puncture to preset position in the 3D-Slicer group was higher than that in the CT group:100.00%(175/175)vs.81.14%(142/175),there were statistical differences(χ^(2)=34.26,P<0.05).The hematoma clearance rate after the surgery for 1,3 and 7d in the 3D-Slicer group were higher than those in the CT group:(87.93±8.54)%vs.(66.43±7.99)%,(92.48±10.31)%vs.(89.52±11.74)%,(96.37±10.22)%vs.(94.30±9.25)%,there were statistical differences(P<0.05).After the surgery for 7 d,the levels of glutathione peroxidase(GSH-Px),superoxide dismutase(SOD)and catalase(CAT)in the 3D-Slicer group were higher than those in the CT group:(121.36±10.59)U/L vs.(109.14±9.05)U/L,(92.80±8.63)μg/L vs.(81.45±9.11)μg/L,(24.64±5.43)U/L vs.(20.84±3.47)U/L;while the level of malondialdehyde(MDA)was lower than that in the CT group:(4.42±0.57)μmol/L vs.(5.19±0.51)μmol/L,there were statistical differences(P<0.05).After the surgery for 3 months,the rate of favorable prognosis in the 3D-Slicer group was higher than that in the CT g

关 键 词：颅内出血 高血压性 导管插入术 最小侵入性外科手术 治疗结果 3D-Slicer软件 

分 类 号：R651.12[医药卫生—外科学]