中国实用神经疾病杂志2025，Vol.28Issue(4)：427-431,5.DOI:10.12083/SYSJ.240371
改良无框架立体定向手术治疗脑干出血的疗效观察
Effect of improved frameless stereotactic surgery for the treatment of brainstem hemorrhage
摘要
Abstract
Objective To investigate the effectiveness of frameless stereotactic puncture drainage guided by multimodal image fusion and neuronavigation in the treatment of brainstem hemorrhage.Methods A retrospective study was conducted on the clinical data of 35 patients with brainstem hemorrhage in the Neurosurgery Department of the Second Affiliated Hospital of Zhengzhou University from October 2018 to October 2023,using multimodal image fusion and neuronavigation guided frameless stereotactic precise puncture and suction drainage technology.Brain CT was reexamined 24 hours after the operation,which was to judge the amount of residual hematoma in brainstem,and whether to determine to inject urokinase drainage or not according to the amount of residual hematoma.GCS was performed before and after surgery.All the patients were followed up 30 days after the operation to understand their survival status,and mRS assessment was performed on survivors.Results All the 35 patients had successful puncture at one time,and there was no death during operation.Twenty-four hours after operation,the volume of residual intracranial hematoma in 35 patients was(3.8±1.2)mL,and the hematoma clearance rate was(61.3±26.4)%.The preoperative GCS score was(6.9±3.1)points,and the postoperative GCS score was(9.6±3.2)points,there was statistical difference in GCS score before and after operation(P<0.05).After 30 days of following-up,30 patients survived and 5 patients died.The mortality was 14.3%,and the mRS score was(3.8±1.0)points in the survivors.Conclusion The effect of multimodal image fusion combined with neuronavigation guided frameless stereotactic puncture and drainage in the treatment of brainstem hemorrhage is good,which can effectively remove brainstem hematoma,relieve the pressure of hematoma on brain stem,avoid secondary injury,reduce the mortality and disability rates,and improve the recovery.关键词
脑干出血/继发性脑损伤/多模态/无框架立体定向/神经导航/影像融合/血肿抽吸引流术Key words
Brainstem hemorrhage/Secondary brain injury/Multimodal image fusion/Frameless stereotactic/Neuronavigation/Image fusion/Hematoma suction flow分类
临床医学引用本文复制引用
娄金峰,杨璨宇,王在斌,姜帆,陶胜忠,牛光明..改良无框架立体定向手术治疗脑干出血的疗效观察[J].中国实用神经疾病杂志,2025,28(4):427-431,5.基金项目
河南省科技攻关项目(编号:232102310279) （编号:232102310279）
