【摘要】 【目的】探讨血肿穿刺引流术中使用个性化3D打印手术导板进行辅助定位在脑出血患者中的应用价值。【方法】92例脑出血患者，随机分为两组，每组46例。观察组采用个性化3D打印手术导板辅助定位下血肿穿刺引流术，对照组采用CT定位下血肿穿刺引流术。比较两组患者手术情况、术后生活质量[健康调查量表36(SF-36)评分]、神经功能[美国国立卫生研究院卒中量表(NIHSS)评分],术后再出血及继发性脑水肿的发生情况。【结果】观察组定位时间短于对照组，剩余血肿体积低于对照组(P<0.05);观察组一次穿刺成功率、血肿清除率、引流管位置准确率均高于对照组(P<0.05);观察组术后1周SF-36总评分高于对照组(P<0.05),术后半年SF-36各维度及总评分均高于对照组(P<0.05);观察组术后半年NIHSS评分低于对照组(P<0.05);观察组术后再出血、继发性脑水肿发生率低于对照组(P<0.05)。【结论】个性化3D打印手术导板辅助定位下血肿穿刺引流术可有效提高术中定位准确度，缩短定位时间，提高一次穿刺成功率，改善脑出血患者的神经功能及生活质量，并能降低术后并发症发生率，值得临床推广应用。更多还原

【Abstract】 【Objective】 To investigate the efficacy of personalized 3D-printed surgical guide plate-assisted localization of hematoma puncture and drainage in patients with cerebral hemorrhage.【Methods】A total of 92 patients with cerebral hemorrhage were randomly divided into two groups, with 46 cases in each. The observation group underwent hematoma puncture and drainage with the assistance of a personalized 3D-printed surgical guide plate, while patients in the control group received CT-guided hematoma puncture and drainage. Surgical parameters, postoperative quality of life(measured by the SF-36 scale), neurological function [National Institutes of Health Stroke Scale(NIHSS) score], and incidence of postoperative rebleeding and secondary cerebral edema were compared between the two groups.【Results】The observation group had a shorter localization time and smaller residual hematoma volume compared with the control group(P<0.05). The rates of first-attempt puncture success, hematoma clearance, and correct drainage tube placement in the observation group were significantly higher than those in the control group(P<0.05). One week after surgery, the SF-36 total score in the observation group was higher than that in the control group(P<0.05), and at six months postoperatively, all SF-36 dimensions and total scores were significantly higher in the observation group(P<0.05). Six months after surgery, the NIHSS score of the observation group was lower than that of the control group(P<0.05). The incidences of postoperative rebleeding and secondary cerebral edema were significantly lower in the observation group(P<0.05).【Conclusion】Personalized 3D-printed surgical guide plate-assisted localization in hematoma puncture and drainage can effectively improve intraoperative localization accuracy, shorten localization time, increase first-attempt success rate, enhance neurological function and quality of life in patients with cerebral hemorrhage, and reduce postoperative complications. It is worthy of clinical application and promotion.更多还原