3D Slicer软件辅助定位去骨瓣减压术治疗重型颅脑损伤患者的临床效果  

Clinical effect of decompressive craniectomy via 3D Slicer software adjuvant localization in the treatment of patients with severe craniocerebral injury

作　　者：高翔 李明 龚海姣 肖倩 李瑶 GAO Xiang;LI Ming;GONG Haijiao;XIAO Qian;LI Yao(Department of Neurosurgery,Fourth People′s Hospital of Langfang,Langfang 065700,Hebei,China)

机构地区：[1]廊坊市第四人民医院神经外科,河北省廊坊市065700

出　　处：《广西医学》2023年第5期506-510,共5页Guangxi Medical Journal

基　　金：河北省廊坊市科技支撑计划项目(2020013123)。

摘　　要：目的探讨3D Slicer软件辅助定位去骨瓣减压术治疗重型颅脑损伤患者的临床效果。方法回顾性分析80例重型颅脑损伤患者的临床资料,根据手术方法分为对照组与观察组,各40例。对照组采用传统去骨瓣减压术治疗,观察组采用3D Slicer软件辅助定位去骨瓣减压术治疗。比较两组患者手术前后的颅内压、动脉血乳酸水平、美国国立卫生研究院卒中量表(NIHSS)评分,以及术后3个月的预后良好率及术后3个月内的并发症发生率。结果两组患者的颅内压、动脉血乳酸水平及NIHSS评分均有随时间而降低的趋势(均P<0.05),其中,观察组术后24 h、术后72 h的颅内压,术后72 h的动脉血乳酸水平,以及术后1个月、术后3个月的NIHSS评分均低于对照组(均P<0.05)。术后3个月,观察组预后良好率高于对照组,并发症发生率低于对照组(均P<0.05)。结论与传统去骨瓣减压术相比,3D Slicer软件辅助定位去骨瓣减压术能更有效地降低重型颅脑损伤患者的颅内压及动脉血乳酸水平,更好地改善脑组织缺血缺氧状态,减轻神经功能缺损,降低术后并发症发生率,改善患者预后。Objective To explore the clinical effect of decompressive craniectomy via 3D Slicer software adjuvant localization in the treatment of patients with severe craniocerebral injury.Methods The clinical data of 80 patients with severe craniocerebral injury were retrospectively analyzed,and they were assigned to control group or observation group according to the operation methods,with 40 cases in each group.The control group was treated with conventional decompressive craniectomy,and the observation group was treated with decompressive craniectomy via 3D Slicer software adjuvant localization.The pre-and post-operative intracranial pressure,arterial blood lactic acid level,and National Institutes of Health Stroke Scale(NIHSS)score,as well as 3-month postoperative favorable prognosis rate and incidence rate of complications were compared between the two groups.Results The intracranial pressure,arterial blood lactic acid level and NIHSS score of patients in both groups presented a trend of decline over time(all P<0.05),therein the intracranial pressure 24 and 72 hours after operation,and arterial blood lactic acid level 72 hours after operation,as well as 1-and 3-month postoperative NIHSS scores in the observation group were lower than those in the control group(all P<0.05).After 3 months of operation,a higher favorable prognosis rate and a lower incidence rate of complications were observed in the observation group as compared with the control group(all P<0.05).Conclusion Compared with conventional decompressive craniectomy,decompressive craniectomy via 3D Slicer software adjuvant localization can more effectively decrease intracranial pressure and arterial blood lactic acid level in patients with severe craniocerebral injury,and preferably ameliorate ischemic and hypoxia states of brain tissues,relieve neurological function defect,decrease postoperative incidence rate of complications,and ameliorate patients′prognosis.

关 键 词：重型颅脑损伤 3D Slicer软件 去骨瓣减压术 颅内压 神经功能 预后 

分 类 号：R651.15[医药卫生—外科学]