| Objective: In this study,we compared the therapeutic effects of 3D printed navigation template assisted neuroendoscopy for the removal of intracranial hematoma and simple neuroendoscopy for the removal of intracranial hematoma,and explored the clinical application value of 3D printed navigation template assisted neuroendoscopy for the treatment of cerebral hemorrhage in the basal ganglia.Methods: From June 2020 to December 2021,76 patients treated by neurosurgery in People’s Hospital of Inner Mongolia Autonomous Region and the Seventh Medical Center of General Hospital of People’s Liberation Army were selected as the research object.Written informed consent was signed with the consent of patients and their families,and patients were divided into different groups according to the operation mode.The control group was treated by endoscopic intracranial hematoma removal,while the research group was treated by 3D printed navigation template assisted by endoscopic intracranial hematoma removal.Before the operation,the basic data of patients were collected,including age,male-female ratio,operative side,whether it broke into ventricle,blood pressure,preoperative hematoma volume,systolic blood pressure,preoperative GCS score,etc.SPSS22.0 was used to compare the basic data,residual hematoma volume,hematoma clearance rate,operation time,postoperative ICU stay time,total stay time,incidence and mortality of postoperative complications including intracranial infection,pulmonary infection and venous thrombosis of lower limbs,and mRS scores were used to evaluate the patients’ prognosis at 7 days,30 days and 90 days after operation,and the changes of mRS scores at 7 days and 90 days were compared.Results: Seventy-six patients were divided into a 3D printed navigation template aided neuroendoscopy group(n = 34)and a neuroendoscopy group(n = 42).The age,gender,operation side,whether or not to break into the ventricle,blood pressure,preoperative hematoma volume,preoperative GCS score,and preoperative systolic blood pressure of the two groups were compared(P > 0.05).There was no statistically significant difference between the two groups,and they were comparable.(1)The residual hematoma volume in the 3D printing navigation template group was(3.80±1.11)ml,and that in the neuroendoscope group was(4.54±0.74)ml,with P=0.001(P<0.05).Compared with that in the 3D printing navigation template group,the residual hematoma volume in the two groups was less than that in the neuroendoscope group,and the difference was statistically significant.(2)The evacuation rates of hematoma in the 3D printing navigation template group and the neuroendoscope group were(91.71±1.36)% and(89.56±1.33)%,respectively,P<0.001.Compared with the other two groups,the evacuation rate of hematoma in the 3D printing navigation template group was greater than that in the neuroendoscope group,and the difference was statistically significant.(3)The operation time was(189.88±23.15)min in the 3D printing navigation template group and(209.67±32.46)min in the neuroendoscope group,P=0.004(P<0.05).Compared with the 3D printing navigation template group,the operation time in the two groups was significantly shorter than that in the neuroendoscope group,and the difference was statistically significant.(4)For complications,the lung infection rate was 44.12%in the 3D printing navigation template group and 47.62% in the neuroendoscope group,while the intracranial infection rate was 5.88% and 2.38% in the neuroendoscope group.The incidence of lower extremity venous thrombosis was11.76% in the 3D printing navigation template group and 16.67% in the neuroendoscope group.The mortality rates of the 3D printing navigation template group and the neuroendoscope group were 2.94% and 7.14%,respectively.P=0.456(P > 0.05).There was no statistically significant difference in complications between the two groups.(5)For the hospitalization time,P = 0.414(P > 0.05)was found in the postoperative ICU of the 3D printing navigation template group compared with that of the neuroendoscope group,and P = 0.339(P > 0.05)was found in the total hospitalization time of the 3D printing navigation template group compared with that of the neuroendoscope group.There was no significant difference in the hospitalization time between the two groups.(6)For the assessment of prognosis using mRS score,the good prognosis on the 7th day after operation in both the 3D printed navigation template group and the neuroendoscope group was 0,the good prognosis on the 30 th day after operation in the 3D printed navigation template group was5.88%,and the good prognosis on the 30 th day after operation in the neuroendoscope group was 9.52%,P = 0.875(P > 0.05).The good prognosis on the 90 th day after operation was 23.53% in the 3D printing navigation template group,and that on the90 th day after operation was 19.04% in the neuroendoscope group,with P = 0.634(P > 0.05).Besides,the changes of mRS scores on the 7th day after operation and on the 90 th day after operation were as follows: P = 0.215(P > 0.05)in the 3D printing navigation template group compared with that in the neuroendoscope group.There was no statistically significant difference in the prognosis between the two groups.Conclusion:There is no significant difference in postoperative complications,postoperative ICU stay,total hospital stay or prognosis between the 3-D print navigation template-assisted neuroendoscopic intracranial hematoma evacuation and the simple neuroendoscopic intracranial hematoma evacuation.However,the short operation time,small amount of postoperative residual hematoma and high hematoma removal rate in the 3-D printed navigation template-assisted neuroendoscopic intracranial hematoma removal can effectively reduce the damage to patients during the operation,and it is a safe and simple surgical treatment. |
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