Department of Neurosurgery, Ninth People Hospital Afliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China.
Neurosurg Rev. 2024 Jul 26;47(1):359. doi: 10.1007/s10143-024-02614-7.
This study aims to compare the outcomes of robot-assisted drainage and conservative treatment in minor basal ganglia hemorrhage (10ml< hemorrhage volume ≤ 30 ml) patients with neurological dysfunction, and analyze patients treated with robot-assisted drainage in order to optimize this treatment strategy.
In a retrospective study conducted in December 2021 to December 2023, minor basal ganglia cerebral hemorrhage patients with neurological dysfunction were enrolled from the Department of Neurosurgery, Shanghai Ninth People's Hospital. The patients included both the surgical (robot-assisted drainage) and conservative groups. The efficacy of robot-assisted drainage compared with conservative treatment in patients with minor cerebral hemorrhage and neurological dysfunction was evaluated by modified Rankin Scale (mRS) score after 3 months, muscle strength (grade 1 to 5) and cost of hospitalization.
Of the patients included, 23 received robot-assisted drainage and 20 received conservative treatment. There were no significant differences in gender, age, history of hypertension and diabetes, muscle strength and mRS score at admission. Female patients accounted for 32.6%, and male patients accounted for 67.4%. About 90% of the patients enrolled had a pre-existing hypertension history. The mRS score after 3 months indicated that prognosis of the patients was significantly better in the surgical treatment group than the conservative treatment group (favorable prognosis 69.57% VS. 35%, P = 0.034) while the patients underwent surgery paid higher hospital bills than patients treated conservatively.
Compared with traditional conservative treatment, robot-assisted drainage surgery is more helpful to improve the prognosis of patients with minor basal ganglia hemorrhage (volume ≤ 30mL) accompanied by neurological dysfunction. Robot assisted surgery can safely and effectively remove the hematoma of minor basal ganglia hemorrhage, and there were 69.6% of surgery group patients had a good prognosis in this study.
本研究旨在比较神经功能障碍的小基底节脑出血（10ml<出血量≤30ml）患者采用机器人辅助引流与保守治疗的疗效，并对采用机器人辅助引流的患者进行分析，以优化该治疗策略。
本回顾性研究于 2021 年 12 月至 2023 年 12 月在上海第九人民医院神经外科进行，纳入神经功能障碍的小基底节脑出血患者。患者分为手术（机器人辅助引流）组和保守组。采用改良 Rankin 量表（mRS）评分、肌力（1 级至 5 级）和住院费用评估机器人辅助引流与保守治疗对小脑出血伴神经功能障碍患者的疗效。
共纳入 23 例行机器人辅助引流和 20 例行保守治疗的患者。两组患者的性别、年龄、高血压和糖尿病史、入院时肌力和 mRS 评分均无显著差异。女性患者占 32.6%，男性患者占 67.4%。纳入的患者约 90%有既往高血压病史。3 个月后的 mRS 评分显示手术治疗组的预后明显优于保守治疗组（预后良好率 69.57% VS. 35%，P=0.034），但手术组患者的住院费用高于保守治疗组。
与传统保守治疗相比，机器人辅助引流术更有助于改善伴有神经功能障碍的小基底节脑出血（体积≤30ml）患者的预后。机器人辅助手术可以安全有效地清除小基底节脑出血的血肿，在本研究中，有 69.6%的手术组患者预后良好。
