微创穿刺清除术在基底节区脑出血治疗中的临床应用研究  

Clinical study of minimally invasive punctural evacuation in the treatment of basal ganglion region cerebral hemorrhage

作　　者：陆川[1] 林建虎[1] 巴华君[1] 陈献东[1] 陈茂华[1] 孙军[1] 

机构地区：[1]温州市第二人民医院神经外科,325000

出　　处：《中国医师进修杂志》2012年第11期25-27,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的研究基底节区脑出血应用YL-1型一次性使用颅内血肿粉碎抽吸穿刺针行血肿清除术治疗的临床效果。方法收集2007年1月至2011年5月应用YL-1型一次性使用颅内血肿粉碎抽吸穿刺针行血肿清除术治疗的62例高血压基底节区脑出血患者（微创穿刺清除术组），与同期行内科保守治疗的高血压基底节区脑出血60例患者（内科保守治疗组）作对照，比较两组人院时、治疗3周后的神经功能缺损评分、血肿清除率以及就诊后6个月的生存质量。结果微创穿刺清除术组和内科保守治疗组入院时神经功能缺损评分[（23．6±18．4）分比（23．4±17．8）分]比较差异无统计学意义（P＞0．05）；治疗3周后，微创穿刺清除术组神经功能缺损评分、血肿清除率明显优于内科保守治疗组[（14．6±12．4）分比（20．1±18．4）分，（92．3±5．4）％比（79．5±13-8）％]（P＜0．05）。就诊后6个月门诊对患者进行随访，微创穿刺清除术组生存质量效果良好率为81．7％（49／60），明显高于内科保守治疗组的67．2％（39／58），差异有统计学意义（P＜0．05）。结论微创穿刺颅内血肿清除术具有创伤小、疗效确切的特点，能够有效、快速解决颅内血肿占位压迫效应，降低患者致残率，提高生存质量。Objective To study the clinical effect of YL-1 type hematoma puncture needle in the treatment of basal ganglion region cerebral hemorrhage. Methods Sixty-two patients with hypertensive basal ganglion region cerebral hemorrhage were treated by YL-1 type hematoma puncture needle from January 2007 to May 2011 （minimally invasive punctural evacuation group）, of which, 60 patients were treated by conservative treatment （conservative treatment group） as control,compared two groups of neural function defect score, hematoma clearance rate on admission, after 3 weeks treatment, and quality of life after 6 months. Results Neural function defect score on admission of minimally invasive punetural evacuation group was （23.6 ± 18.4） scores,while （23.4 ± 17.8） scores in conservative treatment group,the difference was not statistically significant （P 〉0.05）. After 3 weeks＇ treatmentlneural function defect score and hematoma clearance rate of minimally invasive punctural evacuation group was superior to conservative treatment group [ （14.6 ± 12.4） scores vs. （20.1 ± 18.4） scores, （92.3 ± 5.4）% vs. （79.5 ± 13.8）% ] （P 〈 0.05 ）. After 6 months＇ treatment,the good rate of quality of life in minimally invasive punctural evacuation group was 81.7% （49/60）, which was significantly increased compared with thai of conservative treatment group [67.2% （39/58）] （P 〈 0.05）. Conclusions The minimally invasive punctural evacuation in the treatment of basal ganglion region cerebral hemorrhage has small invasion, better prognosis, effective and fast decompression of intracranial hematoma, reducing disability rates, improvement of the quality of life, which could be a beneficial complement for traditional therapies.

关 键 词：脑出血 外科手术 微创性 预后 

分 类 号：R651.1[医药卫生—外科学]