生命科学仪器2023，Vol.21Issue(4)：79-83,5.DOI:10.11967/2023210814
3D-Slicer软件辅助微创血肿清除术治疗高血压脑出血的临床疗效及预后影响因素分析
Analysis of clinical efficacy of 3D-Slicer software-assisted minimally invasive hematoma evacuation in the treatment of hypertensive intracerebral hemorrhage and its prognostic factors
摘要
Abstract
Objective:To explore the clinical efficacy of 3D-Slicer software-assisted minimally invasive hematoma evacuation for hypertensive intracerebral hemorrhage(HICH)and its prognostic factors.Methods:The clinical data of 96 cases with HICH treated in our hospital from November 2018 to November 2021 were retrospectively ana-lyzed.According to the treatment scheme in the data,they were divided into 48 cases in the study group and 48 ca-ses in the control group.The control group was treated with microscope hematoma removal,and the study group was treated with 3D slicer software assisted neuroendoscopic hematoma removal.The hematoma disappearance time,operation time,intraoperative bleeding,hematoma clearance rate,good prognosis and postoperative compli-cations were observed and recorded.At the same time,90 days after operation,the cases were divided into good prognosis group(MRS score 0～3)and poor prognosis group(MRS score≥3)by modified Rankin Scale(MRS).The prognostic factors of cases with hypertensive intracerebral hemorrhage were analyzed by univariate and multi-variate analysis.ROC was used to analyze the predictive value of 3D-Slicer for the prognosis of surgical treatment of hypertensive cerebral hemorrhage.Results:The operation time,intraoperative blood loss and hematoma disap-pearance time in the study group were shorter than those in the control group(P＜0.05),and the hematoma clear-ance rate and prognosis were higher than those in the control group(P＜0.05).The incidence of complications in the study group(4.17％)was lower compared with control group(22.92％)(P＜0.05).Univariate analysis showed that the prognosis was related to baseline NIHSS score,baseline GCS score,operation method,operation time,in-traoperative blood loss,3D-Slicer measurement of cerebral hemorrhage,and hematoma clearance rate(P＜0.05).Surgical method[OR(95％CI)=3.931(1.849-8.361)],operation time[OR(95％CI)=2.724(1.617-4.588)],intraoperative blood loss[OR(95％CI)=3.404(1.883-6.153)],and 3D-Slicer measurement of cere-bral hemorrhage Both volume[OR(95％CI)=3.543(1.991-6.304)]and hematoma clearance rate[OR(95％CI)=3.677(1.944-6.952)]were risk factors affecting the prognosis of hypertensive intracerebral hemorrhage(P＜0.05).ROC curve analysis showed that the AUC of 3D-Slicer for predicting the prognosis of hypertensive intrac-erebral hemorrhage was 0.901(95％CI:0.851-0.951),and the sensitivity and specificity were 90.63％and 80.33％.respectively.Conclusion:3D slicer software assisted neuroendoscopic hematoma removal has a good clinical effect for HICH.It can not only effectively reduce the operation time and intraoperative bleeding,improve the hema-toma removal rate,but also effectively improve the prognosis.3D slicer measurement of intracerebral hemorrhage can be used as a related factor to evaluate the postoperative prognosis of cases with HICH.关键词
3D-Slicer软件/血肿清除术/高血压脑出血/疗效/预后Key words
3D-Slicer software/hematoma evacuation/hypertensive intracerebral hemorrhage/efficacy/progno-sis分类
医药卫生引用本文复制引用
袁春苗,姚光伟,代红,王小明,匡德利..3D-Slicer软件辅助微创血肿清除术治疗高血压脑出血的临床疗效及预后影响因素分析[J].生命科学仪器,2023,21(4):79-83,5.基金项目
秦皇岛市重点研发计划科技支撑项目 （）
编号:202101A119项目名称:软通道颅内血肿钻孔引流术对老年性脑出血血脑屏障保护的探究 （）
