实用医学杂志 ›› 2022, Vol. 38 ›› Issue (23): 2996-3001.doi: 10.3969/j.issn.1006⁃5725.2022.23.019

• 新技术新方法 • 上一篇    下一篇

手术机器人辅助穿刺抽吸与内镜辅助下清除治疗基底节区中小型高血压性血肿临床效果分析

盛文国1 王聪2 龙连圣1 谢虎1 王伟1 李夏良1 吴钟华1 施顺孝1 方文杰1 莫成平1 姜礼鹏1 关义豪1 沈立1 于晓敏1   

  1. 1 湖州学院附属南太湖医院神经医学科(浙江湖州313000);2 芜湖市第一人民医院(安徽芜湖241000)

  • 出版日期:2022-12-10 发布日期:2022-12-10
  • 通讯作者: 龙连圣 E⁃mail:longls8898@163.com
  • 基金资助:

    2021 浙江省医学会临床科研基金项目(编号:2021ZYC⁃A140);2021 湖州市科技计划项目(编号:2021GYB22)

Removal of small and medium⁃sized hematomas in the basal ganglia:surgical robot⁃assisted stereotaxic aspiration vs. endoscopy ⁃assisted debridement

SHENG Wenguo*,WANG CongLONG LianshengXIE Hu WANG WeiLI XialiangWU ZhonghuaSHI ShunxiaoFANG WenjieMO ChengpingJIANG LipengGUAN YihaoSHEN LiYU Xiaomin.   

  1. Department of Neurology,South Taihu Hospital Affiliated to Huzhou University Huzhou 313000,China

  • Online:2022-12-10 Published:2022-12-10

摘要:

目的 探讨手术机器人辅助立体定向穿刺抽吸与内镜辅助下清除基底节区高血压性中小型血肿的临床疗效。方法 回顾性分析 2019 年 4 月至 2021 年 11 月湖州学院附属南太湖医院收治的 118 例基底节区高血压性中小型血肿(25 ~ 55 mL)患者的临床资料,根据治疗方法分为手术机器人辅助立体定向穿刺抽吸组(研究组)、内镜下血肿清除组(对照组),比较两组患者入院的一般临床资料及住院期间并发症发生率、住院时间及出院时偏瘫侧下肢肌力恢复情况。结果 两组患者的一般资料差异无统计学意义(P > 0.05)。两组患者住院期间再出血、应激性溃疡肺部感染、颅内感染发生率、深静脉血栓发生率差异无统计学意义(P > 0.05);住院时间研究组短于对照组(17.32 ± 4.59)d vs.(26.350 ± 4.93)d),差异有统计学意义(P < 0.05);随访 6 个月时偏瘫侧下肢肌力Ⅳ~Ⅴ级占比研究组高于对照组,差异有统计学意义(P <0.05)。结论 手术机器人辅助立体定向穿刺抽吸脑内血肿创伤小,可以缩短患者的住院时间,改善此类患者的预后,提高此类患者的生活质量,值得临床推广。

关键词: 脑出血, 高血压, 手术机器人, 立体定向, 预后

Abstract:

Objective To explore the clinical efficacy of robotic⁃assisted stereotaxic aspiration and endos⁃ copy⁃assisted debridement of hypertensive small and medium⁃sized hematomas in the basal ganglia. Methods The clinical data of 118 patients with hypertensive small and medium⁃sized hematoma(25 ~ 55 mL)in the basal ganglia who were admitted to South Taihu Hospital,Huzhou University from April 2019 to November 2021 were retrospectively analyzed. According to the treatment methods,they were divided into surgical robot⁃assisted stereo⁃ taxic puncture and aspiration group(study group)and endoscopic hematoma removal group(control group). The two groups were compared in terms of the general clinical data on admission,the incidence of complications during hospitalization,the length of hospital stay,and the recovery of lower limb muscle strength on the hemiplegic side at the time of discharge. Results There was no significant difference in the average score and hematoma volume between the two groups(P > 0.05). There was no significant difference in the incidence of rebleeding,stress ulcer pulmonary infection,intracranial infection and deep vein thrombosis between the two groups during hospitalization (P > 0.05). The length of hospital stay in the study group was significantly shorter than that in the control group [(17.32 ± 4.59)d vs.(26.350 ± 4.93)d,P < 0.05)]. After 6⁃month follow⁃up,the proportion of muscle strength of the lower limbs of the hemiplegic side Ⅳ~Ⅴ in the study group was significantly higher than that in the control group(P < 0.05). Conclusion Surgical robot⁃assisted stereotaxic puncture and aspiration for removing intracerebral hematoma is less traumatic. It can shorten the hospitalization duration,improve the prognosis,and improve the quality of life,thereby worthy of clinical promotion. 

Key words:

intracranial and cerebral hemorrhage, hypertension, surgical robot, stereotaxic, prog? nosis ,