Chen Ai, Peng Jie, Luo Tao, Cheng Lu, Wang Qi, Su Jun
Department of Neurosurgery, Nanchuan Hospital of Chongqing Medical University, Chongqing 408400, P.R. China.
X-Ray Department, Nanchuan Hospital Of Chongqing Medical University, Chongqing 408400, P.R. China.
Exp Ther Med. 2025 Jan 9;29(3):47. doi: 10.3892/etm.2025.12797. eCollection 2025 Mar.
The aim of the present study was to evaluate the efficacy and safety of laser localization combined with soft-channel minimally invasive surgery (MIS) for the treatment of cerebral hemorrhage, and to develop stereotactic alternatives that are cost-effective, safe and precise for underdeveloped regions. To meet this aim, 60 patients with cerebral hemorrhage were randomly assigned to the control group (n=30) or the study group (n=30). The patients in the study group were treated with laser localization combined with soft-channel MIS to remove the hematoma, whereas the control group was treated with YL-1 needle puncture to drain the intracranial hemorrhage. All patients underwent successful surgical treatment. The hematoma clearance rate was revealed to be 88.72±2.82% in the study group and 84.50±4.26% in the control group. Both groups achieved residual hematoma volume <10 ml or a hematoma clearance rate >70%, and the difference in the hematoma clearance rate was found to be statistically significant (P<0.05), with the study group having an improved hematoma clearanc2e rate compared with the control group. The median 7-day postoperative Glasgow Coma Scale score was 13.0 [interquartile range (IQR), 12.0, 14.0] for the study group and 12.0 (IQR, 11.0, 13.0) for the control group, indicating an improved outcome in the study group. The puncture accuracy was 100% (30/30) in the study group compared with 76.66% (23/30) in the control group (P<0.05). The hematoma drainage time was found to be significantly shorter in the study group (40.57±8.24 h) compared with that in the control group (56.80±14.40 h) (P<0.05). At the 6-month follow-up, the median modified Rankin Scale score was found to be 2.0 (IQR, 2.0, 3.0) in both groups. Neither group experienced rebleeding, hydrocephalus or cerebral infarction. No intracranial infections occurred in the treatment group, whereas three cases of intracranial infection were observed in the control group. In conclusion, the findings of the present study have shown that laser localization combined with soft-channel MIS is effective and safe in the treatment of cerebral hemorrhage.
本研究的目的是评估激光定位联合软通道微创手术（MIS）治疗脑出血的疗效和安全性，并开发出对欠发达地区具有成本效益、安全且精确的立体定向替代方案。为实现这一目标，将60例脑出血患者随机分为对照组（n = 30）和研究组（n = 30）。研究组患者采用激光定位联合软通道MIS清除血肿，而对照组采用YL-1针穿刺引流颅内出血。所有患者均接受了成功的手术治疗。研究组血肿清除率为88.72±2.82%，对照组为84.50±4.26%。两组均实现残余血肿体积<10 ml或血肿清除率>70%，且血肿清除率差异具有统计学意义（P<0.05），研究组血肿清除率高于对照组。研究组术后7天格拉斯哥昏迷量表评分中位数为13.0[四分位间距（IQR），12.0，14.0]，对照组为12.0（IQR，11.0，13.0），表明研究组预后改善。研究组穿刺准确率为100%（30/30），对照组为76.66%（23/30）（P<0.05）。研究组血肿引流时间明显短于对照组（40.57±8.24 h）（56.80±14.40 h）（P<0.05）。在6个月随访时，两组改良Rankin量表评分中位数均为2.0（IQR，2.0，3.0）。两组均未发生再出血、脑积水或脑梗死。治疗组未发生颅内感染，而对照组观察到3例颅内感染。总之，本研究结果表明，激光定位联合软通道MIS治疗脑出血有效且安全。
