机器人辅助立体定向微创引流手术时机对不同部位高血压脑出血患者预后的影响

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中图分类号 R743.34 R608 文献标识码A 文章编号 2096-7721（2025）08-1379-06

Effect of robot-assisted stereotactic minimally invasive drainage surgery timing on prognosis in hypertensive intracerebral hemorrhage patients with different hemorrhage locations

LU Wanliu， NONG Shengde， HUANG Lide， WEI Wei， HUANG Wuyun， HUANG Jiangang （Department of Neurosurgery，Baise People's Hospital， Baise 533ooo， China）

AbstractObjective：Txploreeoptaltiingofrbotic-assistedstereotacticminimallyinvasivedrainagesurgerforhytesive intracerebralhemorrhage（HICH）atdiferentlocations，aimingtomaximizetherapeuticeficacywhileminimizingpatientrisks. Methods：AtotalofOHCHptientshounderentobotasistedstereotacticiallyinvasivedainagesurgeryataiseeople's HospitalfromJauary2toJauary24wereselectedandrandomlydividedintoulraearly（n=40），arly（n=4O），anddelaed（4） groups based on surgical timing： within 6 h， 6～24 h，and after 24h of onset， respectively. All groups received uniform postoperative managementPrognosisqualityof ifebledingrates，GlasgutcomeScale（GOS）sores，ndActivitisofDailyLiving（Aore werecomparedaong tegoupsndcrossdiferenthmoagelcatio.Results：At1onthostoperativelyGOSsoseigin theultra-earlyandarlygoupstaintedlaedroupitheulra-earloupoutpefoingtearlyoupAt6monts，Do werehigherintheultra-earlyandarlygoupsthaninthdelayedgroup，withtheearlygoupsupassingtheultra-earlygroup.Tedelayed group had a higher rebleeding rate than the early group （P<0.05） . No significant differences were observed in preoperative/postoperative GOS/ ADL scores or rebleeding rates across hemorrhage locations （P>0.05） .However，ultra-early surgery for basal ganglia hemorrhage resulted in lower 1-month GOS scores （P<0.05） ，while delayed surgery for intraventricular hemorrhage led to poorer 6-month ADL scores （P<0.05）.

Conclusion：Earlysugeryimprovesshot-termoutcomesandqualityoflife，whereasdelayedsurgey increassrebleedingriss.Hae locationisnotteominantprogosticfactoutisuancsantateto：ulraarlysrgeryfosalangliaemohageyslow short-temeulcaloyeladsgeryfoalaogailfaloeysical planningshould prioritize timing whileconsidering subtlelocation-specificimpactsforpreciseindividualized treatment.

KeyWordsHypetesiveIacebralHemhage;RobotistedStereotacticMiniallyInvasiveDraagSurgery;SurgicalTing; Prognosis

高血压脑出血是神经外科最常见的急危重症之一，具有发病率高、死亡率高、预后差等特点，不仅严重影响患者的身心健康，还为其家庭和社会带来了巨大负担[-2]。（剩余11854字）