【摘要】 目的 探讨基于三维影像的血肿体积及表面积精准测量在机器人辅助立体定向穿刺术评估治疗脑干出血的应用价值及对预后判断的意义。方法 选取2020年5月至2025年5月吉林大学中日联谊医院收治的25例脑干出血患者，按患者实际治疗方式分机器人组(10例，接受机器人辅助术)和非机器人组(15例，接受传统术)。比较两组一般资料、术前术后血肿体积及表面积、变化量及变化率、术前与术后7 d格拉斯哥昏迷评分(GCS)。结果 手术时间上，机器人组低于非机器人组(P<0.05);性别、吸烟史、饮酒史、体质量指数、年龄、出血到手术时间、术前血肿体积、术后血肿体积、血肿体积变化量及变化率、术前血肿表面积、血肿表面积变化量及变化率、术前GCS评分，两组差异均无统计学意义(P>0.05)。术后血肿体积和表面积较术前均减小(P<0.05),术后7 d时机器人组GCS评分高于非机器人组(P<0.05)。结论 机器人辅助立体定向穿刺术精准测量是有效的诊断评估工具，可实现更优手术规划，与患者早期神经功能恢复显著相关，对预后判断有价值。更多还原

【Abstract】 Objective To explore the application value of precise measurement of hematoma volume and surface area based on three-dimensional imaging in robot-assisted stereotactic puncture for the treatment of brainstem hemorrhage and its significance in prognosis prediction.Methods A total of 25 patients with brainstem hemorrhage admitted to China-Japan Union Hospital of Jilin University between May 2020 and May 2025 were selected.Based on the actual treatment received, they were divided into a robot-assisted group(10 cases undergoing robot-assisted surgery) and a non-robot-assisted group(15 cases undergoing traditional surgery).General data, preoperative and postoperative hematoma volume and surface area, their changes(absolute change and change rate),and Glasgow Coma Scale(GCS) scores before and 7 days after surgery were compared between the two groups.Results In terms of operation time, the robot-assisted group was shorter than the non-robot-assisted group(P<0.05).There were no statistically significant differences between the two groups in gender, smoking history, drinking history, body mass index, age, time from hemorrhage to surgery, preoperative hematoma volume, postoperative hematoma volume, hematoma volume change amount and change rate, preoperative hematoma surface area, hematoma surface area change amount and change rate, and preoperative Glasgow Coma Scale score(P>0.05).Both postoperative hematoma volume and surface area decreased compared with those before surgery(P<0.05).At 7 days after surgery, the GCS score in the robot-assisted group was higher than that in the non-robot-assisted group(P<0.05).Conclusion This accurate measurement serves as an effective diagnostic assessment tool.Its application in robot-assisted stereotactic puncture enables superior surgical planning, demonstrates a significant correlation with early postoperative neurological function recovery in patients, and holds value for prognostic evaluation.更多还原