| Objective To evaluate the clinical application of stereotactic surgery planning system and the diagnosis of photonic CT imaging in the treatment of intracerebral hematoma by using frame stereotactic system,and to analyze and compare the difference between the traditional craniotomy and stereotactic system in the treatment of cerebral hematoma from the aspects of nerve function prognosis and the ability of daily living and surgical complications,so as to provide a reference for improving the clinical treatment level of cerebral hematoma.MethodsThe clinical data of 64 patients with cerebral hematoma from January 1,2014 to December 31,2016 were analyzed by retrospective analysis.The patients were divided into two groups.The observation group was treated with photonic CT stereotactic puncture and aspiration,while the control group was treated with craniotomy.The activities of Daily(ADL)were evaluated by using Scandinavian Stroke scale of Stroke(Scandinavian Stroke scale).The recovery of nervous system function and clinical complications were analyzed and compared between the two groups.The observation group was treated with frame photon CT stereotactic puncture and aspiration assisted by urokinase.The Leksell frame was first fixed to the head of the patient and then the brain hematoma was scanned by photon CT to collect the original scanning data.Leksell surgical planning system was input in the form of optical disk,3D image was reconstructed,hematoma coordinate target was determined,path and orientation were calculated,surgical plan was planned.The recovery of injured nerve function and postoperative complications were observed.Spssl3.0 software was applied to analyze and compare the patients’age,sex,blood pressure,location of hematoma,hematoma volume,postoperative rebleeding,pulmonary infection and stress ulcer.Results The observation group was compared with the control group.The patients were evaluated with Scandinavian Stroke scale(Scandinavian Stroke scale)before operation.There was no significant difference between the two groups(mild:X~2=0.953,moderate:X~2=1.304,severe:X~2=1.857 P>0.05).At 2 weeks after operation,SSS score was used to compare the observation group with the control group.There was a difference between the mild dysfunction group and the control group(X~2=19.458,P<0.05),There was no significant difference in moderate and severe neurological function recovery groups between the two groups(moderate:X~2=2.466,severe:X~2=4.531 P>0.05).The recovery of nerve function in the observation group was significantly better than that in the control group.After one month of follow-up,the activities of Daily activities of ADL were evaluated.The results showed that there was a significant difference between the observation group and the control group(X~2=14.046,P<0.05),there was no statistical difference between observation group and control group in gradeⅢ,ⅣandⅤ.(gradeⅢ:X~2=2.208,gradeⅣ:X~2=2.179,grade V:X~2=2.653 P>0.05).In terms of complications,Although there was no significant difference in intracerebral rebleeding and emergent hemorrhage between the observation group and the control group(rebleeding:X~2=0.354,emergency hemorrhage:X~2=0.843 P>0.05),the incidence of pulmonary infection in the observation group was significantly lower than that in the control group(X~2=7.407,P<0.05).Conclusion 1.the combination of stereotactic instrument,photonic CT and surgical planning system can be used to perform minimally invasive hematoma clearance,which can accurately locate the hematoma in the brain,effectively empty the hematoma in the brain,improve the neurological function of the patient,and thus enhance the ability of daily life of the patient.2.It is a safe,reliable and effective method to treat intracerebral hematoma by using frame stereotactic system to reduce the incidence of postoperative complications,such as pneumonia,and to improve the prognosis of the patients. |
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