CAS-R-2无框架与Leksell框架立体定向仪辅助钻孔引流术治疗高血压性脑出血的对比分析

目的比较CAS-R-2无框架脑立体定向仪与Leksell框架立体定向仪辅助钻孔引流术治疗高血压性脑出血(血肿量20~40 mL)患者的简易性、疗效、安全性、社会经济负担和预后的不同。方法选择聊城市人民医院脑科医院神经外科自2012年12月至2019年12月收治的120例幕上高血压性脑出血患者,其中应用CAS-R-2无框架脑立体定向仪辅助钻孔引流术治疗65例(无框架组),应用Leksell框架立体定向仪辅助钻孔引流术治疗55例(有框架组)。回顾性分析患者的临床资料,比较2组患者的手术时间、术后7 d的血肿排空率、住院期间再出血和颅内感染发生率、住院时间和住院费用、术后6个月改良Rankin量表(mRS)评分的差异。结果无框架组患者的手术时间(0.5±0.1)h vs.(2.2±0.5)h]、住院期间再出血率(0.0%vs.9.1%)和颅内感染发生率(1.5%vs.9.1%)均低于有框架组,差异有统计学意义(P<0.05)。有框架组患者的住院费用低于无框架组,差异有统计学意义(P<0.05)。2组患者术后7 d的血肿排空率、住院时间、治疗后6个月死亡率及mRS评分的差异均无统计学意义(P>0.05)。结论CAS-R-2无框架脑立体定向仪与Leksell框架立体定向仪辅助钻孔引流术治疗高血压性脑出血的疗效和预后相同,但前者操作简易性和安全性高,后者的费用低。

CAS-R-2 frameless and Leksell frame stereotaxic devices used in trepanation and drainage for patients with hypertensive cerebral hemorrhage: a comparative analysis

Objective To compare the simplicity,safety,efficacy,prognoses and economic burden of CAS-R-2 frameless stereotactic device and Leksell frame stereotactic device in assisting surgery for patients with hypertensive cerebral hemorrhage(ICH,hematoma volume:20-40 mL).Methods The clinical data of 120 patients with supratentorial ICH,admitted to our hospital from December 2012 to December 2019,were retrospectively analyzed;trepanation and drainage assisted by CAS-R-2 frameless stereotactic device was performed in 65 patients(frameless group),and trepanation and drainage assisted by Leksell frame stereotactic device was performed in 55 patients(frame group).The differences of surgery time,hematoma evacuation rate 7 d after surgery,incidences of recurrent hemorrhage and intracranial infection during hospitalization,length and expense of hospitalization,and modified Rankin scale(mRs)scores 6 months after surgery were compared between the two groups.Results As compared with those in the frame group,patients from the frameless group had significantly shorter surgery time(0.5±0.1]h vs.2.2±0.5]h),significantly lower incidence of recurrent hemorrhage(0%vs.9.1%)and significantly lower incidence of intracranial infection(1.5%vs.9.1%)during hospitalization(P<0.05).The hospitalization expense of patients from the frame group was significantly lower than that in the frameless group(P<0.05).There were no significant differences in hematoma evacuation rate 7 d after surgery,length of hospital stays,and mortality and mRs scores 6 months after treatment between the two groups(P>0.05).Conclusion For patients with supratentorial ICH,trepanation and drainage assisted by CAS-R-2 frameless stereotactic device has the same curative effect and prognoses as Leksell frame stereotactic one;the former has higher simplicity and clinical safety,and the latter has lower economic burden.