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机器人辅助微创手术治疗小体积自发性丘脑出血的疗效分析。

Efficacy Analysis of Robot-Assisted Minimally Invasive Surgery for Small-Volume Spontaneous Thalamic Hemorrhage.

机构信息

Department of Neurosurgery, The General Hospital of Northern Theater Command (The Original General Hospital of Shenyang Military Area Command), PLA Institute of Neurology, Shenyang, China.

Department of Neurosurgery, The General Hospital of Northern Theater Command (The Original General Hospital of Shenyang Military Area Command), PLA Institute of Neurology, Shenyang, China.

出版信息

World Neurosurg. 2019 Nov;131:e543-e549. doi: 10.1016/j.wneu.2019.07.224. Epub 2019 Aug 6.

Abstract

OBJECTIVE

To test whether robot-assisted surgery can improve prognosis of small-volume thalamic hemorrhage and to provide a surgical basis for treatment of small-volume thalamic hemorrhage.

METHODS

This retrospective study included patients with thalamic hemorrhage and hematoma volume of 5-15 mL treated from December 2015 to December 2018. Patients were divided into an operation group and a nonoperation group. General data, types of hematoma, incidence of complications, Scandinavian Stroke Scale score, and modified Rankin Scale score were recorded and analyzed.

RESULTS

Retrospectively, 84 cases met inclusion criteria: 35 cases in operation group and 49 cases in nonoperation group. At 90 days after onset, mortality was 11.4% in the operation group and 4.1% in the nonoperation group (P > 0.05). The Scandinavian Stroke Scale score in the operation group (43.3 ± 8.5) was higher than in the nonoperation group (36.1 ± 10.0) (P < 0.05). The modified Rankin Scale score in the operation group (2.9 ± 0.3) was lower than in the nonoperation group (3.7 ± 0.2) (P < 0.05). The incidence of pneumonia (8.6%) and renal dysfunction (14.3%) was lower in the operation group than in the nonoperation group (28.6% and 34.7%, respectively) (P < 0.05). There was no significant difference between the 2 groups in the incidence of central fever (5.7% vs. 12.2%), stress ulcer (11.4% vs. 16.3%), and ion balance disturbance (20.0% vs. 26.5%) (P > 0.05).

CONCLUSIONS

Robot-assisted drainage of thalamic hemorrhage can improve prognosis and reduce the incidence of pneumonia and renal dysfunction.

摘要

目的

检验机器人辅助手术是否能改善小体积丘脑出血患者的预后,并为小体积丘脑出血的治疗提供手术依据。

方法

本回顾性研究纳入了 2015 年 12 月至 2018 年 12 月期间收治的 5-15ml 体积的丘脑出血患者。患者分为手术组和非手术组。记录并分析一般资料、血肿类型、并发症发生率、斯堪的纳维亚卒中量表评分和改良 Rankin 量表评分。

结果

回顾性分析符合纳入标准的患者 84 例:手术组 35 例,非手术组 49 例。发病 90d 后,手术组死亡率为 11.4%,非手术组为 4.1%(P>0.05)。手术组斯堪的纳维亚卒中量表评分(43.3±8.5)高于非手术组(36.1±10.0)(P<0.05)。手术组改良 Rankin 量表评分(2.9±0.3)低于非手术组(3.7±0.2)(P<0.05)。手术组肺炎(8.6%)和肾功能不全(14.3%)的发生率低于非手术组(28.6%和 34.7%)(P<0.05)。两组中枢性发热(5.7%比 12.2%)、应激性溃疡(11.4%比 16.3%)和离子平衡紊乱(20.0%比 26.5%)的发生率差异无统计学意义(P>0.05)。

结论

机器人辅助引流丘脑出血可以改善预后,降低肺炎和肾功能不全的发生率。

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