神经外科手术机器人辅助血肿清除术对高血压基底节区脑出血术后神经功能的影响  

Impact of neurosurgical robot assisted hematoma removal surgery on postoperative neurological function in hypertensive basal ganglia intracerebral hemorrhage patients

作　　者：谢虎 盛文国 施顺孝 龙连圣 XIE Hu;SHENG Wenguo;SHI Shunxiao;LONG Liansheng(Department of Neurosurgery,South Taihu Hospital Affiliated to Huzhou College,Huzhou 313000,China)

机构地区：[1]湖州市湖州学院附属医院南太湖医院神经外科,湖州313000

出　　处：《临床神经外科杂志》2025年第1期94-98,共5页Journal of Clinical Neurosurgery

基　　金：浙江省医药卫生科技计划项目(2024XY160)。

摘　　要：目的探究神经外科手术机器人辅助血肿清除术对高血压基底节区脑出血术后神经功能的影响。方法选取2021年3月—2023年9月湖州市湖州学院附属医院南太湖医院神经外科收治的140例高血压性基底节脑出血患者,根据治疗方式分为机器人组(n=77)和引流组(n=63)。引流组采用钻孔引流术治疗,机器人组采用手术机器人辅助血肿清除术治疗。比较两组围术期相关指标、脑血肿和脑水肿情况、皮质脊髓束(CST)的各向异性分值(FA)、生活质量相关评分以及术后并发症。结果机器人组手术时间、呼吸机支持天数、住院时间均短于引流组,尿激酶使用次数、定位误差,术中失血量少于引流组(P<0.05)。机器人组术后残余血肿体积和术后水肿峰值体积均低于引流组,血肿清除率高于引流组(P<0.05)。术后2周及术后3个月,两组健侧和患侧CST的FA值均升高,且机器人组高于引流组(P<0.05)。术后,两组格拉斯哥预后评分(GOS)和巴氏量表(BI)评分均升高,且机器人组高于引流组(P<0.05)。机器人组术后并发症发生率低于引流组(χ^(2)=3.916,P=0.048)。结论神经外科手术机器人辅助血肿清除术治疗高血压基底节区脑出血,有助于提高血肿清除率,改善神经功能,安全可靠。Objective To investigate the impact of neurosurgical robot assisted hematoma removal surgery on postoperative neurological function in hypertensive basal ganglia intracerebral hemorrhage.Methods A total of 140 patients with hypertensive basal ganglia intracerebral hemorrhage admitted to the Department of Neurosurgery,South Taihu Hospital Affiliated to Huzhou College from March 2021 to September 2023,were divided into a robot group(n=77)and a drainage group(n=63)according to treatment method.The drainage group was treated with burr hole drainage,while the robot group was treated with surgical robot assisted hematoma removal surgery.The perioperative related indicators,cerebral hematoma and edema,fractional anisotropy(FA)of corticospinal tract(CST),quality of life related scores,and postoperative complications were compared between the two groups.Results The duration of surgery and ventilator support,and hospital stay in the robot group were shorter than those in the drainage group,and the urokinase uses,location errorand intraoperative blood loss was less than that in the drainage group(P<0.05).The residual hematoma volume and peak edema volume after surgery in the robot group were lower than those in the drainage group,and the hematoma clearance rate was higher than that in the drainage group(P<0.05).At 2 weeks and 3 months after surgery,the FA values of CST on the healthy and affected sides of both groups increased,and the robot group were higher than the drainage group(P<0.05).After surgery,the Glasgow Outcome Scale(GOS)and Barthel Index(BI)scores of both groups increased,and the robot group were higher than the drainage group(P<0.05).The incidence of postoperative complications in the robot group was lower than that in the drainage group(χ^(2)=3.916,P=0.048).Conclusions Neurosurgical robot assisted hematoma removal surgery for hypertensive basal ganglia intracerebral hemorrhage can improve hematoma removal rate,enhance neurological function,and is safe and reliable.

关 键 词：高血压基底节区脑出血 血肿清除术 神经外科手术机器人 脑水肿 

分 类 号：R651[医药卫生—外科学]