机器人辅助立体定向穿刺引流术治疗原发性脑干出血的临床疗效分析

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【中图分类号】R651 【文献标志码】A 【文章编号】1672-7770（2025）06-0617-06

Abstract： Objective To evaluate the clinical efficacy and safety of robot-assisted stereotactic percutaneous drainage in the treatment of primary brainstem hemorrhage. MethodsThe clinical data of 85 patients with primary brainstem hemorrhage admitted to Xingtai Central Hospital from January 2O2O to December 2O23 were analyzed retrospectively. Patients were divided into the robotasisted group（43 cases）and the conservative treatment group（42 cases） based on the treatment modality. The clearance rate of hematoma，neurological outcomes（GOS and mRS scores）， complication rates， inflammatory markers（IL-6，S1Ooβ），and hospitalization costs were compared between the two groups，and a prognostic factor analysis was performed. ResultsThe hematoma clearance rate in the robot-assisted group at 72 hours post-surgery was significantly higher than that in the conservative group. At 3 months post-surgery，the proportion of patients in the robot-assisted group with a GOS score ⩾4 was 69.8% （30/43），compared to 26.2% （11/42）in the conservative group（ P<0.01， ）. At 6 months post-surgery，the proportion of patients in the robot-assisted group with an mRS score of 0-2 was 46.5% （20/43），compared to 21.4% （9/42）in the conservative group （ P=0.03 ）.The incidence rates of stress ulcer（ 4.7% us. 23.8% ）and severe pneumonia （ 9.3% Us. 28. 6% ）in the robot-assisted group were significantly lower than those in the conservative group（ P<0.05， ）．Serum levels of IL-6 and S100β at 72 hours post-surgery in the robot-assisted group were reduced by more than 50% compared to the conservative group（ P<0.05）．The median hospitalization cost in the robot-assisted group（10o 230.O CNY）was significantly higher than that in the conservative treatment group（5O 22O.O CNY）（ P<0.001 ）. Logistic regression analysis showed that the risk of poor prognosis in patients receiving conservative treatment was more than three times higher than that in patients underwent robotic-assisted surgery （ OR=3 . 05）. ConclusionsRobot-assisted stereotactic percutaneous drainage can precisely remove brainstem hematomas， suppress inflammatory responses，and improve neurological function， significantly reducing the risk of systemic complications.

Keywords：primary brainstemhemorrhage； robot-assisted；stereotactic puncture;inflammatory factor； neurological prognosis

原发性脑干出血（primarybrainstemhemorrhage，PBSH）多为高血压性脑干出血（hypertensivebrainstemhemorrhage，HBSH），是高血压脑出血中最严重的亚型，占该类疾病的 6%～10% ，最常见部位发生在桥脑[1]，保守治疗预后差，传统开颅手术因脑干解剖复杂、功能密集，应用受限。（剩余10119字）