Wang Qingbo, Guo Wei, Zhang Tao, Wang Shuangquan, Li Chenglong, Yuan Zhengbo, Wei Qi, Geng Xin, Li Zefu
Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, China.
Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, China.
Front Neurol. 2022 Jun 9;13:905477. doi: 10.3389/fneur.2022.905477. eCollection 2022.
Brainstem hemorrhage has a rapid onset with high mortality and disability rates. In recent years, an increasing number of studies have reported on the surgical treatment of brainstem hemorrhage. The introduction of stereotaxic instruments and navigation systems has improved the accuracy of surgical treatment; however, the popularity of these devices in the primary hospitals is not high. In this study, we introduce laser navigation combined with the XperCT technology to assist in the puncture and drainage of brainstem hemorrhage, aiming to improve surgical accuracy and facilitate the drainage of brainstem hemorrhage in primary hospitals.
A total of five patients (four men and one woman), aged 34-70 years, who underwent hematoma puncture drainage with the assistance of laser navigation combined with XperCT technology at the Binzhou Medical University Hospital, China, between June 2020 and Aug 2021 were included in the study. The brainstem hemorrhages had volumes of 7-18 ml. Statistical analyses of the postoperative puncture deviation distance (distance between the actual puncture end and simulated puncture end) and postoperative improvement were also performed.
The operations were successfully completed in all five patients. The puncture deviation distance was <6 mm in all five patients and <2 mm in two patients. The postoperative hematoma clearance rate was about 70%-90%. Among four patients with respiratory failure, three had improved breathing and resumed spontaneous breathing. Out of three patients with high fever, one showed a substantial decrease in body temperature. There were no cases of postoperative infection. Of the five patients, two recovered consciousness, one died, and two voluntarily gave up further treatment and were discharged.
Laser navigation combined with the XperCT technology could improve the accuracy of surgical puncture. The technique might be convenient for widespread clinical application because of its low trauma, high precision, short operation time, and low operation cost.
脑干出血起病急，死亡率和致残率高。近年来，越来越多的研究报道了脑干出血的外科治疗。立体定向器械和导航系统的引入提高了外科治疗的准确性；然而，这些设备在基层医院的普及程度不高。在本研究中，我们引入激光导航联合XperCT技术辅助脑干出血的穿刺引流，旨在提高手术准确性，便于基层医院进行脑干出血的引流。
本研究纳入了2020年6月至2021年8月在中国滨州医学院附属医院接受激光导航联合XperCT技术辅助血肿穿刺引流的5例患者（4例男性，1例女性），年龄34 - 70岁。脑干出血量为7 - 18 ml。还对术后穿刺偏差距离（实际穿刺终点与模拟穿刺终点之间的距离）和术后改善情况进行了统计分析。
所有5例患者手术均成功完成。5例患者的穿刺偏差距离均<6 mm，2例患者<2 mm。术后血肿清除率约为70% - 90%。4例呼吸衰竭患者中，3例呼吸改善并恢复自主呼吸。3例高热患者中，1例体温大幅下降。无术后感染病例。5例患者中，2例恢复意识，1例死亡，2例自愿放弃进一步治疗并出院。
激光导航联合XperCT技术可提高手术穿刺的准确性。该技术创伤小、精度高、手术时间短、手术成本低，可能便于在临床广泛应用。
