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

摘要： 目的 探讨机器人导航与传统立体定向框架辅助穿刺置管引流术治疗脑干出血的疗效。方法 回顾性分析60例使用机器人导航(机器人组,n=26例)或传统立体定向框架辅助(立体定向组,n=34例)进行手术治疗的脑干出血患者,对比分析各组的手术持续时间、术后第1天血肿清除率、拔管前血肿清除率、再出血率、穿刺准确率、引流管数、引流管拔除天数、合并脑室出血、行脑室外引流术及颅内感染等情况。结果 两组术前特征年龄分布、出血量和GCS评分无统计学差异。机器人组手术时间(114.87±21.29 vs.140.87±23.34;机器人组P＜0.01)显著缩短。机器人组再出血发生率低(0% vs.6.25%)、穿刺准确率较高(100% vs.93.75%)。术后第1天血肿清除率、拔管前血肿清除率、引流管数、引流管拔除天数、合并脑室出血、行脑室外引流术及颅内感染等情况与立体定向框架组相比无统计学差异(P＞0.05)。结论 机器人导航下穿刺引流术治疗脑干出血与立体定向框架辅助治疗脑干出血一样安全有效,但机器人导航可显著缩短手术时间。同时,机器人导航下行穿刺引流术时无框架阻挡,入路更方便、充分,可选择多种穿刺路径。机器人导航是安全、有效治疗脑干出血的更好选择,值得进一步推广。

关键词: 脑干出血, 立体定向, 机器人, 穿刺, 引流