摘要
目的探讨神经内镜手术联合3D打印技术治疗高血压脑出血(HICH)患者的临床效果。方法选取2022—2024年首都医科大学附属北京安贞医院南充医院收治的HICH患者180例作为研究对象,采用随机数字表法将患者分为神经内镜组与3D打印联合组,各90例。神经内镜组患者采用神经内镜手术治疗,3D打印联合组患者采用神经内镜手术联合3D打印技术治疗。比较两组手术时间、术中出血量、血肿清除率、血肿清除效率,术前及术后3 d实验室检查指标[可溶性白介素2受体(sIL-2R)、IL-6、S100β、神经元特异性烯醇化酶(NSE)水平],术前及术后1个月神经功能缺损程度评分量表(NDS)、简易智力状态检查量表(MMSE)及日常生活活动能力(ADL)量表评分,随访3个月再出血及并发症发生情况。结果3D打印联合组手术时间短于神经内镜组,术中出血量少于神经内镜组,血肿清除率、血肿清除效率高于神经内镜组(P<0.05)。术后3 d,3D打印联合组sIL-2R、IL-6、S100β、NSE水平低于神经内镜组(P<0.05)。术后3 d,两组sIL-2R、IL-6水平分别高于本组术前,S100β、NSE水平分别低于本组术前(P<0.05)。术后1个月,3D打印联合组NDS评分分别低于神经内镜组,MMSE、ADL量表评分高于神经内镜组(P<0.05)。术后1个月,两组NDS评分分别低于本组术前,MMSE、ADL量表评分分别高于本组术前(P<0.05)。随访3个月,两组再出血发生率及并发症总发生率比较,差异无统计学意义(P>0.05)。结论神经内镜手术联合3D打印技术治疗HICH可有效缩短患者手术时间,减少术中出血量,提高血肿清除率,减轻炎症及神经功能缺损程度,改善认知功能,提高ADL,降低手术对机体免疫功能的影响,且具有一定安全性。
Objective To explore the efficacy of neuroendoscopic surgery combined with 3D printing technology in the treatment of patients with hypertensive intracerebral hemorrhage(HICH).Methods A total of 180 HICH patients who treated in Nanchong Hospital,Beijing Anzhen Hospital Affiliated to Capital Medical University from 2022 to 2024 were included as study objects,and they were divided into neuroendoscopic group and 3D printing combination group by random number table method,90 cases in each group.Patients in neuroendoscopic group underwent neuroendoscopic surgery,while patients in 3D printing combination group underwent neuroendoscopic surgery combined with 3D printing technology.The surgical time,intraoperative blood loss,hematoma clearance rate,and hematoma clearance efficiency,laboratory test indicators[soluble interleukin-2 receptor(sIL-2R),IL-6,S100β,neuron specific enolase(NSE)levels]before surgery and after 3 days of surgery,scores of Neurological Deficit Scale(NDS),Mini-Mental State Examination(MMSE)and Activity of Daily Living(ADL)Scale before surgery and after 1 month of surgery,incidence of rebleeding and complications at 3 months of follow-up were compared between the two groups.Results Surgical time in 3D printing combination group was shorter than that in neuroendoscopic group,intraoperative blood loss was less than that in neuroendoscopic group,hematoma clearance rate and hematoma clearance efficiency were higher than those in neuroendoscopic group(P<0.05).After 3 days of surgery,sIL-2R,IL-6,S100β,and NSE levels in 3D printing combination group were lower than those in neuroendoscopic group(P<0.05).After 3 days of surgery,sIL-2R,IL-6 levels of the two groups were higher than those before surgery,S100β,NSE levels were lower than those before surgery,respectively(P<0.05).After 1 month of surgery,NDS score in 3D printing combination group was lower than that in neuroendoscopic group,scores of MMSE and ADL Scale were higher than those in neuroendoscopic group(P<0.05).After 1 month of surgery,NDS score of the two groups was lower than that before surgery,scores of MMSE and ADL Scale were higher than those before surgery,respectively(P<0.05).At 3 months of follow-up,there was no significant difference of incidence of rebleeding and complications between the two groups(P>0.05).Conclusion Combined of neuroendoscopic surgery and 3D printing technology can shorten surgical time in the treatment of patients with HICH,reduce intraoperative blood loss,improve hematoma clearance rate,alleviate inflammation and neurological dysfunction degree,improve cognitive function and ADL,and reduce the impact of surgery on immune function of the body,and with a relatively safety.
作者
罗孝全
冯浩
杨荣
LUO Xiaoquan;FENG Hao;YANG Rong(Department of Neurosurgery,Nanchong Hospital,Beijing Anzhen Hospital Affiliated to Capital Medical University/Nanchong Central Hospital,Nanchong 637000,China)
出处
《实用心脑肺血管病杂志》
2025年第10期19-23,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
颅内出血
高血压性
神经内镜手术
3D打印技术
治疗结果
Intracranial hemorrhage,hypertensive
Neuroendoscopic surgery
3D printing technology
Treatment outcome
