[1]吕 东,朱 盛,黄文强,等.3D打印导板引导下微创穿刺引流治疗丘脑出血的临床研究[J].医学信息,2023,36(18):84-89.[doi:10.3969/j.issn.1006-1959.2023.18.015]
　LYU Dong,ZHU Sheng,HUANG Wen-qiang,et al.Clinical Study of 3D Printed Guide Plate Assisted Minimally Invasive Puncture Drainage in the Treatment of Thalamic Hemorrhage[J].Journal of Medical Information,2023,36(18):84-89.[doi:10.3969/j.issn.1006-1959.2023.18.015]
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3D打印导板引导下微创穿刺引流治疗丘脑出血的临床研究()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年18期
页码:
84-89
栏目:
论著
出版日期:
2023-09-15

文章信息/Info

Title:
Clinical Study of 3D Printed Guide Plate Assisted Minimally Invasive Puncture Drainage in the Treatment of Thalamic Hemorrhage
文章编号:
1006-1959（2023）18-0084-06
作者:
吕 东; 朱 盛; 黄文强; 等
（川北医学院附属大竹医院神经外科，四川 大竹 635100）
Author(s):
LYU Dong; ZHU Sheng; HUANG Wen-qiang; et al.
(Department of Neurosurgery,the Dazhu Hospital of North Sichuan Medical College,Dazhu 635100,Sichuan,China)
关键词:
3D打印导板; 血肿穿刺; 丘脑出血
Keywords:
3D printing guide plate; Hematoma puncture; Thalamic hemorrhage
分类号:
R651.1
DOI:
10.3969/j.issn.1006-1959.2023.18.015
文献标志码:
A
摘要:
目的 探讨3D打印导板辅助微创穿刺引流治疗中等量（15~30 ml）丘脑出血的临床效果及预后。方法 回顾性分析我院2016年1月-2022年7月收治的中等量丘脑出血微创穿刺引流治疗患者43例，根据治疗方式不同将传统穿刺引流（根据头颅CT阅片经验性定位）者20例设为传统组，3D打印导板辅助穿刺引流者23例设为3D打印导板组，比较两组手术时间窗、手术时间、术中血肿穿刺次数、血肿抽吸率、术后留置引流管时间、丘脑实质内血肿的残留率、ICU留置时间、并发症发生率，并随访比较术后1、3个月的mRS及SSS评分。结果 两组术前时间窗和手术时间比较，差异无统计学意义（P＞0.05），但3D打印导板组血肿抽吸率高于传统组、引流时间和ICU时间短于传统组、血肿残留率低于传统组，差异有统计学意义（P＜0.05）。两组术后气管切开、颅内再出血占比比较，差异无统计学意义（P＞0.05），但3D打印导板组术后1、3个月SSS评分高于传统组，mRS评分低于传统组，差异有统计学意义（P＜0.05）。结论 3D打印导板未明显延长穿刺引流的术前时间窗及手术时间，但提高了微创穿刺的精准度，避免了多次术中穿刺血肿的损伤，且因穿刺位置理想提高了血肿抽吸率，降低血肿的残留率，较早地解除了血肿的占位效应，改善患者的短期及长期预后，适宜在没有导航的基层医院应用。
Abstract:
Objective To investigate the clinical effect and prognosis of 3D printing guide plate assisted minimally invasive puncture drainage in the treatment of moderate (15-30 ml) thalamic hemorrhage.Methods A retrospective analysis was performed for the clinical data of 43 patients with moderate thalamic hemorrhage, whose were willing to undergo minimally invasive puncture and had in our hospital from January 2016 to July 2022 were selected. Totally 20 patients in traditional group were treated by traditional minimally invasive puncture (the empiric localization base on the skull CT scan) and catheter drainage, 23 patients in 3D printing guide plate group were treated with 3D printing guide plate assisted minimally invasive puncture drainage. The operation time window, operation time, intraoperative hematoma puncture times, hematoma aspiration rate, postoperative indwelling drainage tube time, residual rate of thalamic parenchymal hematoma, ICU indwelling time and complication rate were compared between the two groups. The mRS and SSS scores at 1 and 3 months after operation were followed up and compared.Results There was no significant difference in preoperative time window and operation time between the two groups (P>0.05), but the hematoma aspiration rate of the 3D printing guide plate group was higher than that of the traditional group, the drainage time and ICU time were shorter than those of the traditional group, and the residual rate of hematoma was lower than that of the traditional group, the difference was statistically significant (P<0.05). There was no significant difference in the proportion of tracheotomy and intracranial rebleeding between the two groups (P>0.05), but the SSS score of the 3D printing puncture group was higher than that of the traditional puncture group at 1 and 3 months after operation, and the mRS score was lower than that of the traditional puncture group, the difference was statistically significant (P<0.05).Conclusion The 3D printing guide plate does not significantly prolong the preoperative time window and operation time of puncture and drainage, but it improves the accuracy of minimally invasive puncture and avoids the injury of multiple intraoperative puncture hematomas. Because the puncture position is ideal, the hematoma aspiration rate is improved, the residual rate of hematoma is reduced, the mass effect of hematoma is relieved earlier, and the short-term and long-term prognosis of patients is improved. It is suitable for popularization and application in primary hospitals without navigation.

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更新日期/Last Update: 1900-01-01