Study On Minimally Invasive Puncture Therapy For Hypertensive Cerebral Hemorrhage And The Assistant Application Of 3D-Slice Software

Objective: To explore the value of 3D-Slicer software in assisting minimally invasive hematoma puncture drainage for hypertensive cerebral hemorrhage(HCH)and the effect of different surgical timing on clinical outcome.To identify the factors that influence the prognosis of surgery,and make a basis for improving the efficacy of surgery and improving the quality of life of patients.Method: Clinical data of 99 patients with hypertensive cerebral hemorrhage(HCH)treated with minimally invasive hematoma puncture and drainage(30~60ml)were collected.According to the timing of the operation after the onset of the disease,the patients were divided into the early group(6 ~ 24h)and the delayed group(24h).There were 51 cases in early stage group and 48 cases in delay group.There were no significant differences in gender,age,bleeding volume,bleeding site,history of hypertension,history of diabetes,GCS score,activity of daily living(ADL),and Barthel index(IB)between the two groups(p > 0.05).After the two groups of cases were treated with minimally invasive puncture and drainage,the postoperative complications(pulmonary infection,upper gastrointestinal bleeding,post-operative brain edema,rebleeding),mortality and the daily living capacity(ADL)after 6 months were observed,compared and statistically to evaluate the surgical timing and clinical effect of minimally invasive puncture and drainage.This paper introduces the application method,clinical value and precautions of 3D-Slicer software,and further evaluates the timing,clinical effect and treatment precautions of minimally invasive puncture drainage.Result: Postoperative complications of 51 cases(in early stage group)and 48cases(in delay group)in this study were shown as follows.The early group showed6 cases of pulmonary infection(11.76%),4 cases of gastrointestinal bleeding(7.84%),D level of brain edema in 1 cases after the operation(1.96%).In contrast,there were 14 cases of pulmonary infection(29.17%),11 cases of digestive tract hemorrhage(22.92%)and 8 cases of grade D brain edema(16.67%)in the delayed group There was significant difference between the two groups(Pearson?2 test,p <0 05).There were 4 cases in the early group(7.84%)and 2 cases in the delayedgroup(4.17%).Comparisons between the two groups showed that there was no significant difference in the incidence of rebleeding between the two groups(Fisher exact probability test,P > 0.05).Prognosis at 6 months after operation as follows:There were 44 cases(86.27%)with good prognosis in the early group,21 cases(43.75%)in the delayed group,;5 disabled patients(9.8%)in the early stage group and 19 disabled patients in the delayed group;In the early group,2 cases(3.92%)died and 8 cases(16.67%)died in the delay group;These data showed a statistically significant difference(P < 0.01).Conclusion:1.The patients treated with minimally invasive puncture drainage in the early stage of hypertensive cerebral hemorrhage have the advantages of less complications,better operative effect,better prognosis and lower mortality rate than those with delayed minimally invasive operation.The best operation time was 6~24hours after hypertensive cerebral hemorrhage,and the patients benefited more.The results of minimally invasive hematoma puncture and drainage were good in patients with hypertensive cerebral hemorrhage in 30 ~ 60 ml.2.3D-Slicer software was simple,quick,easy to master,and had low requirements on equipment;3D-Slicer software could be based on head CT or MRI.The three-dimensional images of skull and hematoma were established and the volume of intracranial hematoma was calculated.The accuracy of the method was high,which provided the basis for clinicians to choose the correct operation mode and perfect the preparation before operation.3D-Slicer software-assisted minimally invasive puncture and drainage of hematoma significantly improved the success rate of the operation compared with the traditional body surface positioning manual puncture operation.3.3D-Slicer software-assisted minimally invasive puncture drainage has not high equipment requirements,simple operation,and short use time,and the operation time of3.3D-Slicer software-assisted minimally invasive puncture drainage is not high,and the operation time is short.Accurate location,less postoperative complications,good prognosis,suitable for promotion in grass-roots hospitals.