Department of Neurosurgery, Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology
摘要：目的 探讨机器人辅助下立体定向穿刺引流术在治疗脑脓肿的临床应用。方法 回顾性分析武汉同济医院2016年01月至2022年10月诊治的46例脑脓肿患者的临床资料。28例行开颅切除手术治疗（开颅组），18例行机器人辅助下立体定向穿刺术治疗（穿刺组）。观察比较两组患者的一般资料、手术时间、术中出血量、术后住院时间、脓肿清除率、术后并发症发生率及预后等。结果 两组患者的一般情况(性别、年龄、病程、脓肿大小及术前GCS评分)均无明显差异，而穿刺组患者的手术时间、术中出血量、术后住院时间及术后并发症发生率均明显低于开颅组，术后6月GOS评分穿刺组明显高于开颅组，且差异均有统计学意义(P<0．05)；而穿刺组脓肿清除率和开颅组并无明显差异；结论 机器人辅助下行脑脓肿穿刺引流是一种简便、安全、精准的微创手术治疗方式，可缩短手术时间及术后住院时间，降低并发症发生率，改善患者预后，在临床中的应用价值明显并可进一步推广。
Abstract：Objective To explore the efficacy of Robotic-assisted stereotactic puncture, aspiration and drainage for patients with brain abscess. Methods A retrospective analysis was performed of 46 patients with brain abscess in our department from January 2016 to October 2022. We divided the patients into two groups: craniotomy group (n=28) and stereotactic puncture group (n=18). Data on clinical characteristics, operation time, the mean blood loss in operation，postoperative length of hospital stay, abscess clearance rate, the incidence rate of postoperative complications, and prognosis were retrospectively reviewed and compared between these two groups. Results There were no significant differences in the general characteristics (gender, age, duration of illness, abscess size, and preoperative Glasgow Coma Scale score) between the two groups of patients. The mean operation time, the mean blood loss in operation, the postoperative hospital stay and the incidence rate of postoperative complications of the puncture group were significantly lower than those of the craniotomy group, and the postoperative GOS score in puncture group was significantly higher than that of the craniotomy group. The difference between the two groups was statistically significant (P<0.05)，but no significant difference in abscess clearance rate between the puncture group and the craniotomy group. Conclusion Robot-assisted stereotactic puncture, aspiration and drainage for patients with brain abscess is a simple, safe, and precise minimally invasive surgical treatment method. It could shorten the surgical time and postoperative hospital stay, also reduce the incidence rate of complications, and improve the the patients, prognosis. Its clinical value has been demonstrated and it could be further promoted in clinical practice.