关键词: 脑干出血, 立体定向, 机器人, 穿刺, 引流

Abstract: Objective This study aims to explore the therapeutic efficacy of robot navigation and conventional stereotactic framework-assisted puncture drainage in the treatment of brainstem hemorrhage. Methods Retrospective analysis was conducted on 60 patients with brainstem hemorrhage who underwent surgical treatment using either robot-assisted navigation (robot group,n=26) or conventional stereotactic frame assistance (stereotactic group,n=34).A comparative analysis was performed to evaluate various parameters including surgery duration,hematoma clearance rate on the first postoperative day,hematoma clearance rate before extubation,rebleeding rate,puncture accuracy rate,number of drainage tubes used,days until removal of drainage tubes,incidence of concomitant intraventricular hemorrhage,performance of external ventricular drainage procedure,and occurrence of intracranial infection in each group. Results The age distribution,bleeding volume,and GCS score did not show any statistically significant differences between the two groups prior to surgery.However,the robot group exhibited a notably shorter operation time (114.87±21.29 vs.140.87±23.34; P＜0.01).Additionally,the robot group demonstrated a lower rebleeding rate (0% vs.6.25%) and higher puncture accuracy rate (100% vs 93..75%).There were no statistically significant differences observed in postoperative hematoma clearance rate on the first day,hematoma clearance rate before extubation,number of drainage tubes used,days until removal of drainage tubes,incidence of concomitant intraventricular hemorrhage,performance of external ventricular drainage procedure or intracranial infection when compared to the stereotactic group (P > 0.05). Conclusion Robot navigation-guided puncture drainage treatment for brainstem hemorrhage demonstrates comparable safety and efficacy to stereotactic frame-assisted treatment for brainstem hemorrhage,while significantly reducing the operation time.At the same time,the absence of frame obstruction during robot navigation-guided puncture drainage enhances convenience and comprehensiveness by offering multiple puncture paths.Therefore,robot navigation represents a superior choice for safe and effective management of brainstem hemorrhage,warranting further promotion.

Key words: Brainstem hemorrhage, Stereotactic, Robotic, Puncture, Drainage