Efficacy Analysis of Robot-Assisted Minimally Invasive Surgery for Small-Volume Spontaneous Thalamic Hemorrhage
Efficacy Analysis of Robot-Assisted Minimally Invasive Surgery for Small-Volume Spontaneous Thalamic Hemorrhage
复制标题
机器人辅助丘脑小量自发性出血微创手术疗效分析
DOI：
10.1016/j.wneu.2019.07.224
复制
发表时间：
2019-11-01
影响因子：
2
通讯作者：
Tao, Yingqun
中科院分区：
文献类型：
--
作者：
Wang, Yu;Jin, Hai;Tao, Yingqun
目的：为检验机器人辅助手术是否能改善小体积丘脑出血的预后，为小体积丘脑出血的治疗提供手术依据，方法：本回顾性研究纳入2015年12月至2018年12月期间接受治疗的丘脑出血患者，血肿体积为5-15 ml。将患者分为手术组和非手术组。结果：回顾性分析84例患者，其中手术组35例，非手术组49例。发病后90天手术组病死率为11.4%，非手术组病死率为4.1%（P> 0.05）。斯堪的纳维亚卒中量表评分手术组（43.3 ± 8.5）分高于非手术组（36.1 ± 10.0）分（P < 0.05）。改良兰金量表评分手术组（2.9 ± 0.3）低于非手术组（3.7 ± 0.2）（P < 0.05）。手术组肺炎和肾功能不全的发生率分别为8.6%和14.3%，均低于非手术组的28.6%和34.7%（P < 0.05）。中枢性发热（5.7% vs.12.2%）、应激性溃疡（11.4% vs.16.3%）、离子平衡紊乱（20.0% vs.26.5%）的发生率两组比较差异无显著性（P > 0.05）。
OBJECTIVE: To test whether robot-assisted surgery can improve prognosis of small-volume thalamic hemorrhage and to provide a surgical basis for treatment of small-volume thalamic hemorrhage.METHODS: This retrospective study included patients with thalamic hemorrhage and hematoma volume of 5-15 ml treated from December 2015 to December 2018. Patients were divided into an operation group and a nonoperation group. General data, types of hematoma, incidence of complications, Scandinavian Stroke Scale score, and modified Rankin Scale score were recorded and analyzed.RESULTS: Retrospectively, 84 cases met inclusion criteria: 35 cases in operation group and 49 cases in nonoperation group. At 90 days after onset, mortality was 11.4% in the operation group and 4.1% in the nonoperation group (P> 0.05). The Scandinavian Stroke Scale score in the operation group (43.3 +/- 8.5) was higher than in the nonoperation group (36.1 +/- 10.0) (P < 0.05). The modified Rankin Scale score in the operation group (2.9 +/- 0.3) was lower than in the nonoperation group (3.7 +/- 0.2) (P < 0.05). The incidence of pneumonia (8.6%) and renal dysfunction (14.3%) was lower in the operation group than in the nonoperation group (28.6% and 34.7%, respectively) (P < 0.05). There was no significant difference between the 2 groups in the incidence of central fever (5.7% vs. 12.2%), stress ulcer (11.4% vs. 16.3%), and ion balance disturbance (20.0% vs. 26.5%) (P > 0.05).CONCLUSIONS: Robot-assisted drainage of thalamic hemorrhage can improve prognosis and reduce the incidence of pneumonia and renal dysfunction.