定向置管吸引术与内科保守治疗基底节区少量出血的疗效分析  

Therapeutic effects of aspiration with a directional soft tube and conservative treatment on mild hemorrhage in the basal ganglion

作　　者：骆锦标[1] 彭彪[1] 全伟[1] 曹志恺[1] 肖国才[1] 吕建平[1] 徐建明[1] 何志文[1] 

机构地区：[1]广州市第一人民医院神经外科,广东广州510180

出　　处：《南方医科大学学报》2008年第8期1352-1353,1357,共3页Journal of Southern Medical University

基　　金：国家"十一五"科技支撑计划(2007BA107A13)

摘　　要：目的初步探讨应用定向置管吸引术与内科保守治疗基底节区少量出血的疗效对比。方法将75例高血压少量脑出血(10～30ml),随机分成定向置管治疗组(微创组)和内科保守治疗组(内科组);两组GCS评分均为11～15分;其中微创组36例,内科组39例。结果在血肿完全清除或吸收时间比较上,微创组平均3.8d<内科组平均24d;近期(1月)疗效随访,神经功能恢复优良率,微创组58%>内科组29%,远期(6月)疗效随访,功能恢复良好率,微创组50%>内科组16%,微创组无死亡,内科组2例,临床住院费用微创组平均5136.3元,内科组平均11843.6元。结论微创组较内科组能明显缩短住院治疗时间,功能恢复优良率高,降低了死亡率,临床费用也大为减少。Objective To compare the therapeutic effects of aspiration via a directional soft tube and conservative treatment in patients with mild hemorrhage in the basal ganglion. Methods Seventy-five patients with mild cerebral hemorrhage （10-30 ml） were randomly divided into two groups for aspiration treatment with minimally invasive directional soft tube placement （minimally invasive group, n=36） and conservative treatment （medication group, n=39）. The patients in the two groups had comparable mean GCS scores of 11-15 on admission. The clinical outcomes of the patients were compared between the two groups. Results In the minimally invasive group, complete removal or absorption of the hemotoma occurred within an average of 3.8 days, significantly shortened in comparison with the 24 days in the medication group. The short-term （1 month） follow-up of the patients showed good neurological recovery in 58% of the patients in the minimally invasive group, significantly greater than the rate of 29% in the medication group; 6 months after the treatment, good neurological recovery was achieved in 50% of the patients in the minimally invasive group, but only 16% in the medication. No death occurred in the minimally invasive group, and 2 patients died in the medication group. The cost of hospitalization averaged 5136.3 Yuan in the minimally invasive group and 11843.6 Yuan in the medication group. Conclusion Compared with conservative treatment, the minimally invasive treatment with soft tube placement can significantly shorten the hospital stay, promote neurological function recovery, lower the mortality rate, and reduce the cost of hospitalization.

关 键 词：定向置管 高血压 基底节区 脑出血 保守治疗 

分 类 号：R651.1[医药卫生—外科学]