数字重建技术辅助颞下入路清除脑干出血的治疗体会

打开文本图片集

【中图分类号】 R651 【文献标志码】 A 【文章编号】 1672-7770（2025）06-0601-05

Abstract： ObjectiveTo evaluate the clinical eficacy and technical key points digital reconstruction technology-assisted subtemporal approach microsurgery for brainstem hemorrhage evacuation. MethodsThe clinical data 13 patients with brainstem hemorrhage treated with digital technology-assisted surgery from January 2O2O to December 2O24 in the Department Neurosurgery，the First Afiliated Hospital Jishou University were analyzed retrospectively. Preoperative CT/CTA/CTV data were used to construct 3D models for surgical pathway planning， combined with intraoperative ultrasound real-time localization to perform hematoma evacuation via the subtemporal approach. Outcomes including hematoma evacuation extent， operative time（from entering to leaving the operating room），postoperative neurological improvement status，and complication rates were assessed.ResultsWith digital reconstruction technology assistance，the average hematoma evacuation extent reached 98.8% . The Glasgow coma scale score improved by （ 4.6±3.2， ）points at 72 hours postoperatively，with no critical vascular or neural injuries observed during surgery. The 3O-day survival rate was 76.9% .ConclusionsDigital reconstruction technology can precisely optimize the subtemporal surgical approach， improving the safety and efficacy brainstem hemorrhage evacuation.However，the individualized application based on the surgeon's experience remains essential.

Key words： digital reconstruction；subtemporal approach；brainstem hemorrhag

脑干出血约占自发性脑出血的 5%～10% ，开颅手术往往面临视野局限、定位偏差等挑战，病死率高达 50%～80% 。（剩余9170字）