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3D 打印导航模具在脑干出血穿刺引流中的应用。

Application of a 3D-Printed Navigation Mold in Puncture Drainage for Brainstem Hemorrhage.

机构信息

Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, Shandong, China.

Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, Shandong, China.

出版信息

J Surg Res. 2020 Jan;245:99-106. doi: 10.1016/j.jss.2019.07.026. Epub 2019 Aug 12.

Abstract

BACKGROUND

Brainstem hemorrhage is an acute and severe neurosurgical disease. Cerebral hemorrhage is surgically treated via hematoma puncture drainage because of its minimally invasive nature. However, the placement of puncture must be extremely accurate due to the special anatomical location of the brainstem and its physiological functions. The present study aimed to evaluate whether the application of a three-dimensional (3D)-printed navigation mold achieved good outcomes in the surgical treatment of brainstem hemorrhage.

MATERIAL AND METHODS

The present study included seven patients (three men and four women aged 40-56 y) who underwent 3D print-assisted hematoma puncture drainage between June 2016 and March 2018 at Binzhou Medical University Hospital. The amount of brainstem hemorrhage was 15-47 mL. We analyzed the basic surgical conditions, deviation distance, and postoperative clinical improvement.

RESULTS

In all cases, the operation was completed successfully; no patient died or contracted an infection intraoperatively. The end of the puncture tube was located in the hematoma cavity in all cases. The deviation distance ranged from 2.5 to 7.2, and this distance gradually reduced with improvements in the technique. The hematoma drainage achieved satisfactory postoperative outcomes, with improvements in symptoms such as respiratory failure and hyperthermia.

CONCLUSIONS

Use of a 3D-printed navigation mold for puncture drainage of brainstem hemorrhage realized the purpose of individualized and precision medicine, which is important in maintaining the vital signs of patients with severe brainstem hemorrhage.

摘要

背景

脑干出血是一种急性且严重的神经外科疾病。由于其微创的性质,脑出血通过血肿穿刺引流进行手术治疗。然而,由于脑干的特殊解剖位置及其生理功能,穿刺的放置必须非常精确。本研究旨在评估三维(3D)打印导航模具在脑干出血的手术治疗中的应用是否能取得良好的效果。

材料和方法

本研究纳入了 2016 年 6 月至 2018 年 3 月期间在滨州医学院附属医院接受 3D 打印辅助血肿穿刺引流的 7 名患者(3 名男性和 4 名女性,年龄 40-56 岁)。脑干出血量为 15-47mL。我们分析了基本的手术条件、偏差距离和术后临床改善情况。

结果

所有病例均成功完成手术,术中无患者死亡或感染。所有病例的穿刺管末端均位于血肿腔内。偏差距离为 2.5-7.2,随着技术的改进,该距离逐渐减小。血肿引流术后效果满意,呼吸衰竭和高热等症状均有改善。

结论

使用 3D 打印导航模具进行脑干出血穿刺引流实现了个体化和精准医疗的目的,这对于维持严重脑干出血患者的生命体征非常重要。

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