Peng Chen, Yang Liu, Yi Wang, Yidan Liang, Yanglingxi Wang, Qingtao Zhang, Xiaoyong Tang, Tang Yongbing, Jia Wang, Xing Yu, Zhiqin Zhu, Yongbing Deng
Department of Neurosurgery, Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing, China.
QINYING Technology Co., Ltd., Chongqing, China.
Front Neurosci. 2022 Mar 11;16:850179. doi: 10.3389/fnins.2022.850179. eCollection 2022.
Minimally invasive puncture and drainage (MIPD) of hematomas was the preferred option for appropriate patients with hypertensive intracerebral hemorrhage (HICH). The goal of our research was to introduce the MIPD surgery using mixed reality holographic navigation technology (MRHNT).
We provided the complete workflow for hematoma puncture using MRHNT included three-dimensional model reconstruction by preoperative CT examination, puncture trajectory design, immersive presentation of model, and real environment and hematoma puncture using dual-plane navigation by wearing special equipment. We collected clinical data on eight patients with HICH who underwent MIPD using MRHNT from March 2021 to August 2021, including the hematoma evacuation rate, operation time, deviation in drainage tube target, postoperative complications, and 2-week postoperative GCS.
The workflow for hematoma puncture using MRHNT were performed in all eight cases, in which the average hematoma evacuation rate was 47.36±9.16%, the average operation time was 82.14±15.74 min, and the average deviation of the drainage tube target was 5.76±0.80 mm. There was no delayed bleeding, acute ischemic stroke, intracranial infection, or epilepsy 2 weeks after surgery. The 2-week postoperative GCS was improved compared with the preoperative GCS.
The research concluded it was feasible to perform the MIPD by MRHNT on patients with HICH. The risk of general anesthesia and highly professional holographic information processing restricted the promotion of the technology, it was necessary for technical innovation and the accumulation of more case experience and verification of its superiority.
对于合适的高血压脑出血（HICH）患者，微创血肿穿刺引流术（MIPD）是首选治疗方法。本研究的目的是介绍使用混合现实全息导航技术（MRHNT）进行的MIPD手术。
我们提供了使用MRHNT进行血肿穿刺的完整工作流程，包括通过术前CT检查进行三维模型重建、穿刺轨迹设计、模型的沉浸式呈现、真实环境以及通过佩戴特殊设备使用双平面导航进行血肿穿刺。我们收集了2021年3月至2021年8月期间8例接受MRHNT辅助MIPD治疗的HICH患者的临床资料，包括血肿清除率、手术时间、引流管靶点偏差、术后并发症以及术后2周的格拉斯哥昏迷量表（GCS）评分。
所有8例患者均完成了使用MRHNT的血肿穿刺流程，其中平均血肿清除率为47.36±9.16%，平均手术时间为82.14±15.74分钟，引流管靶点平均偏差为5.76±0.80毫米。术后2周无迟发性出血、急性缺血性卒中、颅内感染或癫痫发作。术后2周的GCS评分较术前有所改善。
本研究得出结论，MRHNT辅助下对HICH患者进行MIPD手术是可行的。全身麻醉风险和高度专业化的全息信息处理限制了该技术的推广，有必要进行技术创新并积累更多病例经验以验证其优越性。
