颅内压监测联合3D打印技术治疗高血压脑出血的疗效
王 炬 冯 光 赵敬河 张 明 韩冰莎 任志强 栗艳茹 杨 帆 李 娇
河南省人民医院 河南省脑血管病医院 郑州大学人民医院，河南 郑州 450003
通信作者：冯光
【摘要】 目的 探讨颅内压监测联合 3D 打印技术在高血压脑出血患者中的临床应用。方法 回顾 性分析河南省人民医院神经外科 2019-01—2021-04 收治的应用 3D 打印技术治疗的 83 例高血压基底节区脑出血患者，其中辅助使用颅内压监测 43 例，单纯使用 3D 打印技术 40 例。分析 2 组患者术后临床治疗效果（GOS 评分）、不良事件发生率（脑疝、二次开颅手术、颅内感染、肾功能损伤）。结果 颅内压监测联合 3D 打印组 GOS 分级Ⅰ级 2 例，Ⅱ级 4 例，Ⅲ级 4 例，Ⅳ级 22 例，Ⅴ级 11 例，其中恢复良好（Ⅳ级＋Ⅴ 级）33 例，良好率 76.7%。3D 打印组 GOS 分级Ⅰ级 4 例，Ⅱ级 6 例，Ⅲ级 14 例，Ⅳ级 10 例，Ⅴ级 6 例，其中恢复良好 16 例，良好率 40.0%，2 组临床有效率比较差异有统计学意义（P<0.05）。颅内压监测联合 3D 打印组术后不良事件发生率明显低于 3D 打印组，差异有统计学意义（P<0.05）。结论 颅内压监测是 3D 打印微创穿刺治疗高血压基底节区脑出血的有效辅助方式。
【关键词】 高血压脑出血；颅内压监测；3D 打印技术；颅内血肿清除术
【中图分类号】 R743.34 【文献标识码】 A 【文章编号】 1673-5110 （2022） 08-0941-05
基金项目：河南省省部共建科技攻关项目（编号：SBGJ202002001）
Efficacy of intracranial pressure monitoring combined with 3D printing technology in the treatment of hypertensive intracerebral hemorrhage
WANG Ju，FENG Guang，ZHAO Jinghe，ZHANG Ming，HAN Bingsha，REN Zhiqiang，LI Yanru，YANG Fan，LI Jiao
Henan Provincial People’s Hospital/Henan Provincial Cerebrovascular Disease Hospital/Zhengzhou University People’s Hospital，Zhengzhou 450003，China
Corresponding author：FENG Guang
【Abstract】 Objective To investigate the clinical application of intracranial pressure monitoring combined with 3D printing technology in patients with hypertensive intracerebral hemorrhage. Methods A total of 83 patients with hypertensive basal ganglia hemorrhage treated with 3D printing technique from January 2019 to April 2021 in Henan Provincial People’s Hospital were analyzed retrospectively，including 43 patients who were assisted with intracranial pressure monitoring and 40 patients who were treated with 3D printing technique alone. Postoperative clinical treatment effect （GOS score） and incidence of adverse events （brain hernia，second craniotomy，intracranial infection，renal impairment）were analyzed in both groups. Results In the intracranial pressure monitoring combined with 3D printing group，there were 2 cases of GOS grade Ⅰ，4 cases of grade Ⅱ， 4 cases of grade Ⅲ，22 cases of grade Ⅳ，and 11 cases of grade Ⅴ. Among them，33 cases recovered well （grade Ⅳ + Ⅴ），with a good rate of 76.7%. In the 3D printing group，there were 4 cases of GOS grade Ⅰ，6 cases of grade Ⅱ，14 cases of grade Ⅲ，10 cases of grade Ⅳ，and 6 cases of grade Ⅴ，of which 16 cases recovered well，with a good rate of 40%，and the difference in the clinical effective rate between the two groups was statistically significant（P < 0.05）. The incidence of postoperative adverse events in the intracranial pressure monitoring combined with 3D printing group was significantly lower than that in the 3D printing group，and the difference was statistically significant（P < 0.05）. Conclusion Intracranial pressure monitoring is an effective auxiliary method for 3D printed minimally invasive puncture in the treatment of hypertensive basal ganglia hemorrhage.
【Key words】 Hypertensive intracerebral hemorrhage；Intracranial pressure monitoring；3D printing technology；Evacuation of intracranial hematoma
