摘要
Abstract
Objective To investigate the efficacy of simple augmented reality(AR)-assisted neuroendoscopic lateral fissure-insula approach in the treatment of basal ganglia hemorrhage,and to analyze its technical advantages and application value through a literature review.Methods A retrospective analysis was performed for the clinical data of 78 patients with moderate-volume(30-70 mL)basal ganglia hemorrhage who were admitted to Hanzhong People's Hospital from January 2021 to June 2024,and according to the surgical approach,they were divided into AR endoscopy group with 40 patients and microsurgical craniotomy group with 38 patients.For the patients in the AR endoscopy group,3D-Slicer software was used before surgery to visualize the hematoma and the lateral fissure,and the reconstructed images were imported into a smartphone application of double-exposure camera to use simple AR technology to delineate the hematoma and the lateral fissure and design surgical incision and bone window,while the lateral fissure and the insula were dissected under neuroendoscopy to remove intracerebral hematoma;for the patients in the microsurgical craniotomy group,the lateral fissure and the insula were dissected using small bone flap craniotomy under a microscope to remove intracerebral hematoma.The two groups were compared in terms of general data,time of operation,intraoperative blood loss,residual hematoma volume,length of hospital stay,state of consciousness before and after surgery,postoperative complications,and prognosis.Results Compared with the microsurgical craniotomy group,the AR endoscopy group had a significantly shorter time of operation,significantly lower intraoperative blood loss and residual hematoma volume,and a significantly shorter length of hospital stay(P<0.05).Both groups had a significant increase in Glasgow Coma Scale score after surgery,and the AR endoscopy group had a significantly higher score than the microsurgical craniotomy group(P<0.05).The AR endoscopy group had a significantly lower incidence rate of postoperative complications than the microsurgical craniotomy group(P<0.05).At 6 months of follow-up,both groups had a significant reduction in NIH Stroke Scale score,and the AR endoscopy group had a significantly better score than the microsurgical craniotomy group(P<0.05).The AR endoscopy group also had a significantly higher score of Activities of Daily Living than the microsurgical craniotomy group(P<0.05).Conclusion In the treatment of basal ganglia hemorrhage,simple AR technology-assisted neuroendoscopic lateral fissure-insula approach can help to directly observe the location of the hematoma and the lateral fissure,shorten the time of operation,reduce intraoperative blood loss,improve hematoma clearance rate,reduce the overall incidence of postoperative complications,and improve the quality of life of patients.关键词
增强现实技术/神经内镜/经侧裂入路/基底神经节/微创手术/疗效Key words
augmented reality technology/neuroendoscopy/lateral fissure-insula approach/basal ganglia/minimally invasive surgery/efficacy分类
医药卫生
