立体定向微创清除颅内血肿后运动功能恢复的预测  

Predictor of motor recovery after stereotactic evacuation of intracerebral hematom

作　　者：任思颖[1] 伍国锋[1] 毛远红[1] 熊洁[1] 陈镭[1] 

机构地区：[1]贵阳医学院附属医院急诊神经科,550004

出　　处：《贵州医药》2012年第9期795-798,共4页Guizhou Medical Journal

摘　　要：目的立体定向清除颅内血肿是微创性的外科手术,该手术组织损伤小,有利于血凝块清除。本研究的目的是观察立体定向微创颅内血肿清除术后影响运动功能恢复的因素。方法回顾性分析30例自发性丘脑或豆状核出血并行立体定向颅内血肿清除术的患者。比较患者年龄、术前肌力、血肿量以及血肿清除率,分为运动功能改善组(改善组)及运动功能没有改善组(无变化组)。21例患者归入改善组,9例患者归入无变化组。结果统计学分析显示改善组患者年龄较无变化组明显年轻(P<0.01),然而术前肌力、血肿量以及血肿清除率两组患者之间没有显著性差异。结论显示立体定向颅内血肿清除术改善运动功能,特别是较年轻的患者,表明了术后康复过程中皮质功能重组的重要性,皮质功能重组的过程改善了严重瘫痪患者的运动功能。Objective The stereotactic hematoma evacuation is minimally invasive surgery and is beneficial for clot removal with limited tissue damage.The purpose of this study was to investigate the factors affecting motor recovery after stereotactic hematoma evacuation. Methods This retrospective analysis included 30 patients with spontaneous thalamic or putaminal hemorrhage who underwent stereotactic hematoma evacuation.Compared age,presurgical muscle strength,hematoma volume and removal rate between the group who showed improvement of motor function（improved group） and the group associated with no motor improvement（unchanged group）.Twenty one patients were classified into the improved group and nine patients into the unchanged group. Results Statistical analysis revealed that age in the improved group was significantly younger than in the unchanged group（P0.01）,whereas there was no significant difference in presurgical muscle strength,hematoma volume and removal rate between the two groups. Conclusion The results revealed that stereotactic hematoma evacuation is attributable to the improvement of motor function,especially in the younger population,indicating the importance of cortical reorganization during post-surgical rehabilitation.In addition,this procedure can provide functional improvement in severely disabled patients.

关 键 词：颅内血肿 立体定向颅内血肿清除术 运动功能恢复 预测 皮质功能重组 

分 类 号：R742[医药卫生—神经病学与精神病学]