3D-Slicer辅助定位与CT定位在高血压脑出血手术中的应用观察  

Application of 3D Slicer assisted localization and CT localization in hypertensive intracerebral hemorrhage surgery

作　　者：肖天裕 刘红敏 XIAO Tianyu;LIU Hongmin(Neurosurgery Department of the First People's Hospital of Nankang District,Ganzhou City,Jiangxi Province,341400,China;Imaging Department of Ganzhou People's Hospital,Ganzhou City,Jiangxi Province,341000,China)

机构地区：[1]江西省赣州市南康区第一人民医院神经外科,江西赣州341400 [2]江西省赣州市人民医院影像科,江西赣州341000

出　　处：《蛇志》2025年第1期76-80,共5页Journal of Snake

摘　　要：目的探讨3D-Slicer辅助定位与CT定位在高血压脑出血(HICH)手术中的应用价值。方法选择2020年1月至2024年6月在我院行微创软通道钻孔引流术治疗的HICH患者98例,按随机数字表法分为CT组和3D组各49例。3D组行3D-Slicer辅助定位手术治疗,CT组行常规CT定位手术治疗,比较两组患者的围手术期指标、日常生活能力评分量表(ADL)评分及美国国立卫生研究院卒中量表(NIHSS)评分、并发症和预后情况。结果3D组的手术失血量低于CT组,术后1、3 d的血肿清除率高于CT组,手术用时和住院时间短于CT组,差异均有统计学意义(均P<0.05)。术后3个月,两组患者的ADL评分均较术前高,NIHSS评分均较术前低,而且3D组的ADL评分高于CT组,NIHSS评分低于CT组,差异均有统计学意义(均P<0.05)。3D组的并发症发生率低于CT组,预后情况显著优于CT组,差异均有统计学意义(均P<0.05)。结论与CT定位相比较,HICH术中使用3D-Slicer辅助定位可减少手术创伤,提高血肿清除率,降低并发症发生率,改善患者的临床预后,提高生活质量。Objective To explore the application value of 3D Slicer assisted localization and CT localization in hypertensive intracerebral hemorrhage(HICH)surgery.Methods A total of 98 patients with HICH who were scheduled to undergo minimally invasive soft channel drilling and drainage surgery in our hospital from January 2020 to June 2024 were selected and randomly divided into a CT group and a 3D group,with 49 patients in each group.The 3D group underwent 3D Slicer assisted localization surgery,while the CT group underwent conventional CT localization surgery.The perioperative indicators,Activities of Daily Living(ADL)scores,National Institutes of Health Stroke Scale(NIHSS)scores,complications,and prognosis of the two groups of patients were compared.Results The surgical blood loss of the 3D group was lower than that of the CT group,and the hematoma clearance rate at 1 and 3 days after surgery was higher than that of the CT group.The surgical time and hospitalization time were shorter than those of the CT group,and the differences were statistically significant(all P<0.05).Three months after surgery,the ADL scores of both groups of patients were higher than before surgery,and the NIHSS scores were lower than before surgery.However,the ADL scores of the 3D group were higher than those of the CT group,and the NIHSS scores were lower than those of the CT group,with statistically significant differences(all P<0.05).The incidence of complications in the 3D group was lower than that in the CT group,and the treatment prognosis was significantly better than that in the CT group,with statistically significant differences(all P<0.05).Conclusion Compared with CT localization,the use of 3D Slicrr assisted localization during HCH surgery can reduce surgical trauma,improve hematoma clearance rate,reduce complications,improve patient clinical prognosis,and enhance quality of life.

关 键 词：高血压脑出血 3D-Slicer辅助定位 CT定位 微创软通道钻孔引流术 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R544.1[医药卫生—临床医学]