| Objective To explore the clinical indicators of 3D-slicer by comparing 3D-slicer software-assisted localization of patients with intracranial hematoma under keyhole approach and patients with intracranial hematoma under keyhole approach.The role of software-assisted localization in the removal of intracranial hematomas in the keyhole approach.Whether optical intraprojection is used to locate intracranial lesions has better clinical results than traditional localization,and is worthy of promotion and application in clinical work.Methods This study included retrospectively included 42 patients with basal nucleus hypertensive intracerebral hemorrhage and keyhole approach intracerebral hematoma removal from January 2017 to November 2018.And then included 42 patients from December 2018 to December 2019 in the Department of Neurosurgery of Hulunbeier People's Hospital and treated with hypertensive intracerebral hemorrhage in the basal nucleus and intracerebral hematoma removal in the keyhole approach,as group B,group B patients in 3D-slicer software assisted in the location of descending keyhole approach to hematoma removal.The operation time,hematoma clearance rate,distance between the center point of the hematoma and the bone window,the coincidence rate of the bone window and the hematoma,the incidence of postoperative rebleeding,the range of edema around the largest postoperative hematoma,the average hospitalization day,the prognostic score,Surgery-related complications.Results Compare the general clinical data and preoperative indicators of the two groups of patients,such as preoperative systolic blood pressure,preoperative diastolic blood pressure,mean arterial pressure,preoperative hematoma volume,preoperative GCS,preoperative NIHSS,and surgical site(left / right).It was concluded that P> 0.05,there was no significant statistical difference between the two groups,and they were comparable.Comparison of surgery-related indicators,bone window diameter and bone window area between the two groups,P> 0.05,no statistical significance;group A surgery time was(151.57 ± 38.48)min,group B was(111.90 ± 11.54)min,group A average The length of hospital stay was(15.62 ±3.01)days,and the average length of stay in group B was(12.29 ± 1.33)days,P <0.001,which was significantly different;the hematoma clearance rates in groups A and B were(72.59 ± 4.19)%,(85.48 ± 6.84)%,the maximum volume of edema is(41.98 ± 4.67)ml,(33.52 ± 6.36)ml,and the distance between the center point of hematoma and the center of bone window is(4.96 ± 0.34)cm,(3.91 ± 0.68)cm,bone window In the case of coincidence with the surface projection of the hematoma,28 patients in group A were completely overlapped,the coincidence rate was 66.67%,and 37 patients in group B were completely overlapped,the coincidence rate was 88.10%.The statistical value of each group was P <0.05,which was statistically significant.Among the prognostic related indicators,the GOS score of group A was(2.93 ± 0.84)2 weeks after the operation,26 patients(61.90%)had a good prognosis,the GOS score of group B was(3.40 ± 0.77),and 38 patients(90.04%)had a good prognosis.In the next 2 weeks,the NIHSS score of group A was(9.24 ± 5.11)and that of group B was(6.40 ± 4.73),P <0.05,which was statistically different.The GOS score of group A was(3.00 ± 1.03)at 3 months after operation,and the prognosis was good.26 cases(65.00%),group B(3.56 ± 0.98),good prognosis 34 cases(87.18%);NIHSS score 3 months after operation,group A NIHSS score(7.38 ± 4.72),group B NIHSS score(4.88 ± 3.77),the statistical value of the two groups was compared P <0.05,and the prognosis scores of the two groups were statistically different.Conclusion 1.Patients with 3D-slicer software assisted localization of intracerebral hematoma removal under the keyhole approach,compared with patients with conventional keyhole approach to intracerebral hematoma removal,the operation time is shorter and average.Short hospital days,high hematoma clearance,small maximum edema volume,high coincidence rate of bone window and hematoma projection,short distance between hematomacenter and bone window center,and other significant differences except for the coincidence rate of bone window and hematoma projection.2.3D-slicer software assisted localization of patients with intracranial hematoma removal under the keyhole approach.The GOS scores at2 weeks and 3 months were higher than those under conventional positioning,and the NIHSS scores at 2 weeks and 3 months were lower than those under conventional positioning.Patients with surgery suggest that the short-term prognosis at 2 weeks and the long-term prognosis at 3 months after surgery are assisted by 3D-slicer software.3.3D-slicer software plays an important role in the calculation of preoperative and postoperative hematoma volume,edema volume,bone window and hematoma projection coincidence,and the calculation of the distance between the center of the hematoma and the window of the bone window,which can guide preoperative positioning and postoperative approach Design,and the use of equipment during the use of low requirements,with free,convenient,fast,accurate and other characteristics,it is worth promoting in primary hospitals. |
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