Minimally Invasive Treatment Of Basal Ganglia Cerebral Hemorrhage With 3D-Slicer Localization

Objective: To explore the clinical effect of 3D-Slicer software assisted micro invasive soft channel catheterization and drainage for the patients with basal ganglia intracerebral hemorrhage,and to make accurate preoperative plan for micro invasive soft channel catheterization and drainage for basal ganglia intracerebral hemorrhage.Methods: 67 patients with basal ganglia intracerebral hemorrhage(30ml ≤ hematoma volume < 50 ml,60 years ≤ age < 70 years,8 points ≤ GCS score < 12 points)and minimally invasive soft channel catheterization and drainage were collected and treated in four departments of Neurology of Handan Central Hospital from March 2018 to October 2019.According to whether 3D slicer software was used in preoperative body table positioning,the patients were divided into two groups.3D slicer software was used to process brain CT images There were 34 cases in the 3D slicer localization group(group A)and 33 cases in the non 3D slicer localization group(group B)without 3D slicer software processing.Both groups were followed up for 6 months.The satisfactory rate of puncture was compared between the two groups(reexamination of brain CT immediately after operation,reconstruction of postoperative model with 3D slicer software,measurement of the distance between the puncture target and the center of the hematoma,with the distance within 3mm as satisfactory),the rate of hematoma clearance in 24 hours after operation,the change of GCS score in one week after operation,the retention time of drainage tube and the length of hospitalization.The long-term effect was evaluated according to the GOS score of 6 months after operation.Results: The satisfactory rate of puncture was 100% in group A and 60.6% in group B,with statistical significance(χ 2 = 16.618,P < 0.01).24 hours after operation,the clearance rate of hematoma was(83.42 ± 6.806)% in group A and(69.75 ± 11.298)% in group B.There was significant difference between the two groups(t = 6.444,P < 0.01).One week after operation,the GCS scores of group A(2.50 ± 0.961)and group B(0.42 ± 0.561)were significantly different(t = 8.204,P < 0.01).Retention time of drainage tube: the average retention time of drainage tube was(1.97 ± 0.521)days in group A,and(3.30 ± 1.104)days in group B,the difference was statistically significant(t =-6.288,P < 0.01).Hospitalization days: the average hospitalization days were(12.41 ± 1.50)in group A and(15.33 ± 1.67)in group B,the difference was statistically significant(t =-7.537,P < 0.01).There was no significant difference in gos score between the two groups(P > 0.05).Conclusion: Based on the CT image data of patients with basal ganglia intracerebral hemorrhage,3D slicer can be used to guide the body surface location,puncture direction and depth of minimally invasive soft channel catheterization hematoma drainage operation,improve the puncture satisfaction rate,hematoma clearance rate,accelerate the recovery of nerve function,shorten the time between the catheterization and hospital stay,and there is no significant difference in long-term prognosis.