3D-Slicer软件定位技术在脑内血肿穿刺引流术中的临床应用

目的探讨3D-Slicer软件定位技术在脑内血肿穿刺引流术中的临床应用价值。 方法连续纳入宁夏回族自治区人民医院神经外科自2018年10月至2019年10月收治的基底节区高血压脑出血患者42例，按照定位方法不同分为3D-Slicer软件定位组（观察组，20例）和传统CT定位组（对照组，22例）。观察组在3D-Slicer软件定位下行脑内血肿穿刺钻孔引流术，对照组由术者根据患者CT原始平片定位下行脑内血肿穿刺钻孔引流术。比较2种定位手术患者术中穿刺次数、术后引流管末端到预设穿刺靶点的距离、术后血肿完全吸收时间、术后12 h和3 d的血肿清除率、术后颅内感染和再出血发生率，采用改良Rankin量表评分评估疗效。 结果观察组术中穿刺次数、术后引流管末端到预设穿刺靶点的距离、血肿完全吸收时间显著优于对照组，差异有统计学意义（P<0.05）；观察组术后12 h、3 d的血肿清除率显著高于对照组，差异有统计学意义（P<0.05）；2组患者术后颅内感染率、再出血率比较差异无统计学意义（P>0.05）；随访1个月，观察组预后优于对照组。 结论3D-Slicer软件定位脑内血肿较传统CT定位法更直观、准确，疗效及预后明显优于传统的CT定位法，适合在基层医院推广。

Clinical application of 3D-Slicer software positioning technology in intracerebral hematoma puncture

ObjectiveTo explore the clinical application value of 3D-Slicer software positioning technology in intracranial hematoma puncture. MethodsA total of 42 patients with hypertensive intracerebral hemorrhage in the basal ganglia area admitted to the Department of Neurosurgery, Ningxia Hui Autonomous Region People’s Hospital from October 2018 to October 2019 were analyzed, and according to different positioning methods, they were divided into 3D-Slicer software positioning group (observation group, 20 cases) and traditional CT positioning group (control group, 22 cases). In the observation group, the intracerebral hematoma puncture and drainage was located by 3D-Slicer software, while in the control group, the operator locates the intracerebral hematoma puncture and drainage according to the original CT plain film of the patient. The number of intraoperative punctures, the distance from the end of the drainage tube to the preset puncture targe, the complete absorption time of the postoperative hematoma, the hematoma clearance rate at 12 h and 3 d after surgery, the incidence of intracranial infection and rebleeding were compared between the two kinds of operation patients. The curative effect was evaluated by modified Rankin scale. ResultsThe number of punctures during operation, the distance from the end of the drainage tube to the preset puncture target, and the complete absorption time of the postoperative hematoma in the observation group were significantly better than those in the control group (P<0.05). The hematoma clearance rate of the observation group at 12 h and 3 d after operation was significantly higher than that of the control group, and the difference was statistically significant (P<0.05). There was no significant difference in the rate of intracranial infection and rebleeding between the two groups (P>0.05). Followed up for 1 month, the prognosis of the observation group was better than that of the control group. ConclusionThe 3D-Slicer software is more intuitive and accurate in locating intracerebral hematoma than traditional CT locating method, and its curative effect and prognosis are significantly better than traditional CT locating method, which is suitable for popularization in primary hospitals.