神經外科手術機器人輔助血腫清除術對高血壓基底節區腦出血術后神經功能的影響

【摘要】 目的 探究神經外科手術機器人輔助血腫清除術對高血壓基底節區腦出血術后神經功能的影響。方法 選取2021年3月—2023年9月湖州市湖州學院附屬醫院南太湖醫院神經外科收治的140例高血壓性基底節腦出血患者，根據治療方式分為機器人組（n=77）和引流組（n=63）。引流組采用鉆孔引流術治療，機器人組采用手術機器人輔助血腫清除術治療。比較兩組圍術期相關指標、腦血腫和腦水腫情況、皮質脊髓束（CST）的各向異性分值（FA）、生活質量相關評分以及術后并發癥。結果 機器人組手術時間、呼吸機支持天數、住院時間均短于引流組，尿激酶使用次數、定位誤差，術中失血量少于引流組（P＜0.05）。機器人組術后殘余血腫體積和術后水腫峰值體積均低于引流組，血腫清除率高于引流組（P＜0.05）。術后2周及術后3個月，兩組健側和患側CST的FA值均升高，且機器人組高于引流組（P＜0.05）。術后，兩組格拉斯哥預后評分（GOS）和巴氏量表（BI）評分均升高，且機器人組高于引流組（P＜0.05）。機器人組術后并發癥發生率低于引流組（χ2=3.916，P=0.048）。結論 神經外科手術機器人輔助血腫清除術治療高血壓基底節區腦出血，有助于提高血腫清除率，改善神經功能，安全可靠。

【關鍵詞】 高血壓基底節區腦出血；血腫清除術；神經外科手術機器人；腦水腫

【中圖分類號】 R651" 【文獻標志碼】 B" 【文章編號】 1672-7770（2025）01-0094-05

Impact of neurosurgical robot assisted hematoma removal surgery on postoperative neurological function in hypertensive basal ganglia intracerebral hemorrhage patients

Abstract： Objective To investigate the impact of neurosurgical robot assisted hematoma removal surgery on postoperative neurological function in hypertensive basal ganglia intracerebral hemorrhage. Methods A total of 140 patients with hypertensive basal ganglia intracerebral hemorrhage admitted to the Department of Neurosurgery， South Taihu Hospital Affiliated to Huzhou College from March 2021 to September 2023， were divided into a robot group（n=77） and a drainage group（n=63） according to treatment method. The drainage group was treated with burr hole drainage， while the robot group was treated with surgical robot assisted hematoma removal surgery. The perioperative related indicators， cerebral hematoma and edema， fractional anisotropy（FA） of corticospinal tract（CST）， quality of life related scores， and postoperative complications were compared between the two groups. Results The duration of surgery and ventilator support， and hospital stay in the robot group were shorter than those in the drainage group， and the urokinase uses， location errorand intraoperative blood loss was less than that in the drainage group（Plt;0.05）. The residual hematoma volume and peak edema volume after surgery in the robot group were lower than those in the drainage group， and the hematoma clearance rate was higher than that in the drainage group（Plt;0.05）. At 2 weeks and 3 months after surgery， the FA values of CST on the healthy and affected sides of both groups increased， and the robot group were higher than the drainage group（Plt;0.05）. After surgery， the Glasgow Outcome Scale（GOS） and Barthel Index（BI） scores of both groups increased， and the robot group were higher than the drainage group（Plt;0.05）. The incidence of postoperative complications in the robot group was lower than that in the drainage group（χ2=3.916， P=0.048）. Conclusions Neurosurgical robot assisted hematoma removal surgery for hypertensive basal ganglia intracerebral hemorrhage can improve hematoma removal rate， enhance neurological function， and is safe and reliable.

Key words： hypertensive basal ganglia intracerebral hemorrhage; hematoma removal surgery; neurosurgical robot; cerebral edema

腦出血是一種重要的急性疾病，死亡率和殘疾率很高，占所有卒中亞型的10%～15%，高達70%的病例與高血壓相關［1］。高血壓引起的腦血管破裂后，血液穿透腦實質，導致血腫形成?！?br>