实用老年医学

实用老年医学 ›› 2022, Vol. 36 ›› Issue (6): 588-591.doi: 10.3969/j.issn.1003-9198.2022.06.010

• 临床研究 • 上一篇    下一篇

3D-Slicer辅助定位大面积脑梗死老年病人去骨瓣减压范围内手术治疗研究

高翔, 李明, 龚海姣, 肖倩, 李瑶   

  1. 065700 河北省廊坊市,廊坊市第四人民医院神经外科
  • 收稿日期:2021-04-27 出版日期:2022-06-20 发布日期:2022-06-30
  • 基金资助:
    廊坊市科技支撑计划项目(2020013123)

Study on 3D-Slicer-assisted localization of decompression range of bone flap in the treatment for massive cerebral infarction in elderly patients

GAO Xiang, LI Ming, GONG Hai-jiao, XIAO Qian, LI Yao   

  1. Department of Neurosurgery, Langfang Fourth People’s Hospital, Langfang 065700, China
  • Received:2021-04-27 Online:2022-06-20 Published:2022-06-30

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摘要： 目的 分析3D-Slicer辅助定位大面积脑梗死病人去骨瓣减压范围对老年病人疗效的影响。方法 选择2018～2020年100例未经3D-Slicer治疗病人作为对照组,50组行3D-Slicer治疗病人作为观察组。对照组采用标准大骨瓣减压术治疗,观察组在对照组基础上行3D-Slicer辅助定位。观察脑中线结构移位情况,对2组病人短期预后质量及神经功能进行评估并比较。 结果 术后不同时间点观察组颅内压均显著低于对照组(P<0.01);治疗后观察组格拉斯哥昏迷量表(GCS)评分、恢复良好率显著高于对照组(P<0.01)。Logistic回归分析显示,年龄、受累范围、GCS评分、脑中线位移和治疗方案是影响大面积脑梗死去骨瓣减压治疗病人预后质量的独立影响因素(P<0.05)。 结论 3D-Slicer辅助定位大面积脑梗死病人去骨瓣减压范围可有效提高临床疗效和预后质量,且年龄、受累范围、GCS评分、脑中线位移和治疗方案是病人预后质量的独立影响因素。

关键词: 3D-Slicer辅助定位, 大面积脑梗死, 去骨瓣减压, 预后不良

Abstract: Objective To analyze the effect of 3D-Slicer-assisted localization of decompression range of bone flap in the treatment for massive cerebral infarction in the elderly patients. Methods One hundred elderly patients with massive cerebral infarction who did not receive 3D-Slicer treatment from January 2018 to December 2020 were selected as the control group, and 50 patients treated with 3D-Slicer were enrolled as the observation group. The control group was treated with standard large bone flap decompression, and the observation group was assisted by 3D-Slicer treatment on the basis of the control group. The displacement of midline structure was observed. The quality of short-term prognosis and neurological function were evaluated and compared between the two groups. Results The intracranial pressure in the observation group was significantly lower than that in the control group at different time points after operation (P<0.01). After treatment, the Glasgow Coma Scale (GCS) score and good recovery rate in the observation group were significantly higher than those in the control group (P<0.01). Logistic regression analysis showed that age, extent of involvement, GCS score, midline displacement and treatment plan were the independent influencing factors of the quality of prognosis of the patients with massive cerebral infarction (P<0.05). Conclusions 3D-Slicer-assisted localization of decompression range of bone flap in the elderly patients massive cerebral infarction can effectively improve the clinical efficacy and prognostic quality, and the age, extent of involvement, GCS score, midline displacement and treatment plan might affect the prognostic quality.

Key words: 3D-Slicer-assisted localization, massive cerebral infarction, decompressive craniectomy, poor prognosis

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