机器人引导脑室分区穿刺引流术治疗重型脑室内出血研究  

Severe intraventricular hemorrhage treated with robot-guided ventricular partition puncture drainage

作　　者：廖长品 李忠华 李廷阳[1] 叶静[1] 黄礼德[1] 韦维 韦贤福 杨海燕 潘海涛 陈武 Liao Changpin;Li Zhonghua;Li Tingyang;Ye Jing;Huang Lide;Wei Wei;Wei Xianfu;Yang Haiyan;Pan Haitao;Chen Wu(Department of Neurosurgery,People's Hospital of Baise,Baise 533000,China;Graduate School,Youjiang Medical University for Nationalities,Baise 533000,China;Department of Neurosurgery,Pingguo People's Hospital,Baise 531400,China)

机构地区：[1]百色市人民医院神经外科,百色533000 [2]右江民族医学院研究生院,百色533000 [3]平果市人民医院神经外科,百色531400

出　　处：《中华神经医学杂志》2023年第8期786-793,共8页Chinese Journal of Neuromedicine

基　　金：广西自然科学基金(2023GXNSFAA026478);广西壮族自治区卫生健康委员会科研课题(Z-L20221838)。

摘　　要：目的:探讨机器人引导脑室分区穿刺引流术治疗重型脑室内出血的安全性和有效性。方法:选择自2021年1月至2021年12月于百色市人民医院神经外科接受机器人引导脑室分区穿刺引流术治疗的23例重型脑室内出血患者(试验组),以及接受机器人引导双侧侧脑室穿刺引流术治疗的19例重型脑室内出血患者(对照组)为研究对象,比较2组患者术后24 h内血肿残余量、引流管留置时间、术后30 d内死亡率、术后6个月内并发症(再出血、颅内感染、肺部感染、脑积水)发生率以及术后6个月时格拉斯哥昏迷量表(GCS)评分、日常生活能力(ADL)评分、美国国立卫生研究院卒中量表(NIHSS)评分等临床指标的差异。结果:与对照组相比,试验组患者术后24 h内血肿残余量明显更低[(8.854±3.519)mL vs.(5.668±2.873)mL],引流管留置时间明显更短[(6.580±1.981)d vs.(4.910±2.763)d],术后6个月内脑积水发生率明显更低(42.105%vs.8.696%),术后6个月时GCS评分及ADL评分明显更高、NIHSS评分明显更低[(8.790±2.898)分vs.(11.610±2.948)分;(69.470±12.899)分vs.(78.480±12.861)分;(13.950±5.265)分vs.(9.870±4.124)分],差异均有统计学意义(P<0.05)。结论:机器人引导脑室分区穿刺引流术是一种较安全有效的重型脑室内出血手术方式。Objective To investigate the safety and efficacy of robot-guided ventricular partition puncture drainage in severe intraventricular hemorrhage.Methods A total of 23 patients with severe intraventricular hemorrhage who underwent robot-guided ventricular partition puncture drainage(experimental group)and 19 patients who underwent robot-guided bilateral ventricular puncture drainage(control group)at Department of Neurosurgery,People's Hospital of Baise from January 2021 to December 2021 were included.The differences in residual hematoma volume within 24 h of surgery,drainage tube retention time,mortality rate within 30 d of surgery,incidence of complications(re-bleeding,intracranial infection,pulmonary infection,hydrocephalus)within 6 months of surgery,and scores of Glasgow coma scale(GCS),activity of daily living(ADL),and National Institutes of Health stroke scale(NIHSS)at 6 months after surgery were compared between the 2 groups.Results Compared with the control group,the experimental group had significantly lower residual hematoma volume within 24 h of surgery([8.854±3.519]mL vs.[5.668±2.873]mL),shorter drainage tube retention time([6.580±1.981]d vs.[4.910±2.763]d),lower incidence of hydrocephalus within 6 months of surgery(42.105%vs.8.696%),and significantly higher GCS and ADL scores and lower NIHSS scores at 6 months after surgery(8.790±2.898 vs.11.610±2.948;69.470±12.899 vs.78.480±12.861;13.950±5.265 vs.9.870±4.124,P<0.05).Conclusion Robot-guided ventricular partition puncture drainage is a safe and effective surgical method for severe intraventricular hemorrhage.

关 键 词：脑室内出血 机器人引导手术 穿刺引流术 脑室分区 

分 类 号：R651.12[医药卫生—外科学]