Abstract:

Objective　To analyze the effect of three-dimensional CT reconstruction fusion image in the operation of hypertensive cerebral hemorrhage in the basal nucleus region. Methods　The clinical data of 95 patients with hypertensive cerebral hemorrhage in the basal nucleus region treated at Department of Neurosurgery, Shangluo Central Hospital from March 202 to February 2023 were retrospectively analyzed. The patients were divided into a control group (50 cases), taking neuroendoscopic surgery, and an observation group (45 cases), taking CT 3D reconstruction fusion image + neuroendoscopic surgery, according to whether CT three-dimensional reconstruction fusion image were performed. There were 32 males and 18 females in the control group; they were (57.34±5.16) years old. There were 30 males and 15 females in the observation group; they were (59.11±4.95) years old. The clinical efficacies, operation conditions (operation time, intraoperative bleeding volume, and hospital stay), complications, serum nerve damage indicators [neuron-specific enolase (NSE), neuropeptide Y (NPY), and brain-derived neurotrophic factor (BDNF)] before and 1 week after the surgery, and neurological function [modified Rankin Scale (mRS)] before and 6 months after the surgery were observed and compared between the two groups. χ² and t tests were used for the statistical analysis. Results　The total effective rate of the observation group was higher than that of the control group [95.56% (43/45) vs. 78.00% (39/50)], with a statistical difference (χ²=6.180; P=0.013). The operation time and hospital stay in the observation group were shorter than those in the control group [(89.46±12.17) min vs. (94.37±11.25) min and (9.25±1.13) d vs. (12.16±1.47) d; the intraoperative bleeding volume in the observation group was lower than that in the control group [(64.38±12.47) ml vs. (86.42±11.35) ml]; there were statistical differences (all P<0.05). One week after the surgery, the serum levels of NSE, NPY, and BDNF in the observation group were better than those in the control group [(13.27±2.52) mg/L vs. (18.35±2.41) mg/L and (121.65±6.39) ng/L vs. (168.27±7.28) ng/L, and (7.43±0.82) μg/L vs. (5.62±0.76) μg/L], with statistical differences (all P<0.05). Six months after the surgery, the score of mRS in the observation group was lower than that in the control group (2.02±0.41 vs. 2.58±0.34), with a statistical difference (P<0.001). The incidence rate of complications in the observation group was slightly lower than that in the control group, with no statistical difference (χ²=1.071; P=0.301). Conclusion　CT three-dimensional reconstruction fusion image is safe and effective in the operation of patients with hypertensive cerebral hemorrhage in the basal nucleus region, and can better improve their nerve function.

Key words:

Hypertensive cerebral hemorrhage, CT three-dimensional reconstruction fusion image, Basal ganglia region, Operation, Effect

摘要：

目的　探讨CT三维重建融合影像在基底核区高血压脑出血（HICH）患者手术中的应用效果。方法　本研究为回顾性分析。选取2022年3月至2023年2月期间商洛市中心医院神经外科收治的95例基底核区HICH手术患者的临床资料，按照是否行CT三维重建融合影像分为对照组（神经内窥镜手术）和观察组（CT三维重建融合影像+神经内窥镜手术）。对照组50例，其中男32例，女18例，年龄（57.34±5.16）岁；观察组45例，其中男30例，女15例，年龄（59.11±4.95）岁。观察并比较两组临床疗效、手术情况（手术时间、术中出血量、住院时间）、并发症、术前和术后1周的血清神经损伤指标［神经元特异性烯醇化酶（NSE）、神经肽Y（NPY）、脑源性神经营养因子（BDNF）］、术前和术后6个月的神经功能［改良Rankin量表（mRS）］。采用χ²检验、t检验进行统计分析。结果　观察组总有效率［95.56%（43/45）］高于对照组［78.00%（39/50）］，差异有统计学意义（χ²=6.180，P=0.013）。观察组手术时间、住院时间分别为（89.46±12.17）min、（9.25±1.13）d，短于对照组的（94.37±11.25）min、（12.16±1.47）d；术中出血量为（64.38±12.47）ml，少于对照组的（86.42±11.35）ml；两组上述指标比较，差异均有统计学意义（均P<0.05）。术后1周，观察组血清NSE、NPY、BDNF水平分别为（13.27±2.52）mg/L、（121.65±6.39）ng/L、（7.43±0.82）μg/L，对照组分别为（18.35±2.41）mg/L、（168.27±7.28）ng/L、（5.62±0.76）μg/L；差异均有统计学意义（均P<0.05）。术后6个月，观察组mRS评分为（2.02±0.41）分，低于对照组的（2.58±0.34）分，差异有统计学意义（P<0.001）。观察组并发症发生率稍低于对照组，但差异无统计学意义（χ²=1.071，P=0.301）。结论　CT三维重建融合影像在基底核区HICH中应用安全有效，可更好地改善神经功能。

关键词:

高血压脑出血, CT三维重建融合影像, 基底核区, 手术, 效果