导航辅助早期微侵袭治疗高血压性基底核区脑出血  

Navigation-assisted early minimally-invasive treatment for hypertensive cerebral hemorrhage in the basal ganglion

作　　者：夏寒松 刘向阳 赵明珠 刘卫东 

机构地区：[1]浦东新区浦南医院神经外科,上海200125

出　　处：《中国微侵袭神经外科杂志》2011年第5期213-216,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨神经导航辅助下早期微创治疗高血压性基底核区脑出血的疗效和安全性。方法回顾性分析32例高血压性基底核区脑出血（导航组）的临床资料,均在神经导航辅助下行经额部单孔穿刺血肿,吸除大部分血肿后留置引流。并与同期常规开颅手术治疗高血压性脑出血31例（开颅组）进行比较。结果导航组：手术时间30-120 min,平均（60±21）min;平均住院时间（14±6）d;出院时基本痊愈11例,显著进步11例,进步7例,无变化2例,死亡1例。开颅组：手术时间110-270 min,平均（161±42）min;平均住院时间（38±31）d;出院时基本痊愈5例,显著进步7例,进步11例,无变化1例,恶化1例,死亡6例。导航组手术时间和住院时间均明显短于开颅组（P〈0.01）;导航组术后病人病死率明显低于开颅组（P〈0.01）,而基本痊愈率明显高于开颅组（P〈0.01）。结论神经导航辅助下早期微创治疗高血压性基底核区脑出血,可明显改善病人预后情况。Objective To investigate the efficacy and safety of navigation-assisted early minimally-invasive treatment for hypertensive cerebral hemorrhage（HCH） in the basal ganglion.Methods Clinical data of 32 patients with HCH in the basal ganglion were analyzed retrospectively（navigation group）.The hematoma was punctured through a frontal burr-hole under navigation guidance,and drainage tube was inserted after most hematoma was cleared.The results were compared with the data of 31 patients with HCH in the basal ganglion treated by routine craniotomy in the same period（craniotomy group）.Results In navigation group,the mean time of operation was（60±21） min,ranged from 30 to 120 min.The mean time of hospitalization was（14±6） days.Good recovery was achieved in 11 cases,significant progress in 11,improvement in 7,remained unchanged in 2 and death occurred in 1.While in craniotomy group,the mean time of operation was（161±42） min,ranged from 110 to 270 min.The mean time of hospitalization was（38±31） days.Good recovery was achieved in 5 patients,significant progress in 7,improvement in 11,and no change seen in 1,deterioration in 1 and death occurred in 6.Compared with craniotomy group,the time of operation and hospitalization decreased significantly in navigation group（P0.01）,case fatality rate reduced and basic cure rate rose obviously in navigation group（P0.01）.Conclusions Early minimally-invasive treatment of HCH in the basal ganglion under navigation guidance can significantly improve the prognosis of the patient.

关 键 词：颅内出血 高血压性 脑血管基底神经节出血 神经导航 神经外科手术 

分 类 号：R651.11[医药卫生—外科学] R743.3[医药卫生—临床医学]