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立体定向辅助机器人与框架辅助立体定向钻孔引流术治疗高血压性脑出血患者脑内血肿疗效的对比研究

A comparative study on the efficacy of robot of stereotactic assistant and frame-assisted stereotactic drilling, drainage for intracerebral hematoma in patients with hypertensive intracerebral hemorrhage.

作者信息

Liang Liang, Li Xin, Dong Haiqing, Gong Xin, Wang Guanpeng

机构信息

Liang Liang, Department of Neurosurgery, Baoding No.1 Central Hospital, Baoding 071000, Hebei, China.

Xin Li, Department of Neurosurgery, Baoding No.1 Central Hospital, Baoding 071000, Hebei, China.

出版信息

Pak J Med Sci. 2022 Sep-Oct;38(7):1796-1801. doi: 10.12669/pjms.38.7.5481.

Abstract

OBJECTIVES

To compare the clinical efficacy of robot of stereotactic assistant (ROSA) and frame-assisted stereotactic drilling and drainage for intracerebral hematoma in hypertensive intracerebral hemorrhage (HICH).

METHODS

A total of 142 patients with HICH treated in Baoding First Central Hospital from January 2018 to January 2020 were selected and divided into two groups using a random number table. The ROSA group was treated with a robot of stereotactic assistant, while the frame group underwent frame-assisted stereotactic drilling and drainage for intracerebral hematoma. Surgical duration, postoperative extubation time and complications were compared between the two groups. Venous blood (5 mL) was collected before and three days after surgery. The levels of inflammatory factors [tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6)], as well as neurological function indexes [neuron-specific enolase (NSE), nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF)] were detected by enzyme-linked immunosorbent assay.

RESULTS

The surgical duration, postoperative extubation time, and incidences of infection and postoperative rehemorrhage in the ROSA group were lower than those in the frame group ( < 0.05). In the ROSA group, postoperative TNF-α, hs-CRP, IL-6 and NSE levels were significantly lower while NGF and BDNF levels were higher than those in the frame group (all < 0.05).

CONCLUSION

Compared with frame-assisted stereotactic drilling and drainage for intracerebral hematoma, ROSA in HICH treatment shortens the surgical duration and postoperative extubation time, reduces the risks of infection and rehemorrhage and decreases inflammatory level, which is helpful for the recovery of neurological function.

摘要

目的

比较立体定向辅助机器人(ROSA)与框架辅助立体定向钻孔引流术治疗高血压性脑出血(HICH)脑内血肿的临床疗效。

方法

选取2018年1月至2020年1月在保定市第一中心医院治疗的142例HICH患者,采用随机数字表法分为两组。ROSA组采用立体定向辅助机器人治疗,框架组采用框架辅助立体定向钻孔引流术治疗脑内血肿。比较两组手术时间、术后拔管时间及并发症情况。于术前及术后3天采集静脉血5 mL。采用酶联免疫吸附测定法检测炎症因子[肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)和白细胞介素-6(IL-6)]水平以及神经功能指标[神经元特异性烯醇化酶(NSE)、神经生长因子(NGF)和脑源性神经营养因子(BDNF)]。

结果

ROSA组手术时间、术后拔管时间、感染及术后再出血发生率均低于框架组(<0.05)。ROSA组术后TNF-α、hs-CRP、IL-6及NSE水平均显著低于框架组,而NGF和BDNF水平高于框架组(均<0.05)。

结论

与框架辅助立体定向钻孔引流术治疗脑内血肿相比,ROSA治疗HICH可缩短手术时间和术后拔管时间,降低感染和再出血风险,降低炎症水平,有助于神经功能恢复。

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