改良微创穿刺血肿清除术在治疗基底节脑出血的临床应用  

Removal of improved minimally invasive puncture hematoma in clinical application for the treatment of cerebral hemorrhage in basal ganglia

作　　者：万刚[1] 黄勇[1] 李爱民[1] 

机构地区：[1]民航总医院神经外科,北京100123

出　　处：《湖南中医药大学学报》2013年第2期50-51,共2页Journal of Hunan University of Chinese Medicine

摘　　要：目的评价改良微创血肿清除术在治疗基底节脑出血的临床应用价值。方法将2009年9月至2012年9月我院收治基底节脑出血178例患者随机分为A、B两组,其中A组88例采用传统微创穿刺粉碎清除术;B组90例采用改良微创穿刺血肿清除术治疗;术后随访1年,对比分析两组患者手术时间、术后再出血发生率、病死率、存活患者神经功能缺损评分、Barthel指数日常生活活动(ADL)量表评分之间的差异。结果 A组平均手术时间(55.2±3.4)min,B组平均手术时间(40.3±3.2)min,两组间比较,差异具有统计学意义(P<0.05);术后再出血发生率A组22.7%(20/88),B组23.3%(21/90),术后病死率A组17.0%(15/88),B组17.8%(16/90),两组间比较,差异无统计学意义(P>0.05),存活患者神经功能缺损评分、Barthel指数日常生活活动(Activity of Daily Living Scale,ADL)量表评分之间差异无统计学意义(P>0.05)。结论改良微创血肿清除术能显著降低手术时间,并不增加术后病死率及再出血发生率,近期神经功能缺损与远期疗效(日常生活活动能力)与传统术式无显著差别。Objective To evaluate the clinical value of modified minimally invasive hematoma evacuation in the treatment of basal ganglia hemorrhage. Methods 178 patients with basal ganglia hemorrhage, which were admitted to our hospital from September 2009 to September 2012 were randomly divided into two groups,.88 cases in group A were treated by traditional minimally invasive puncture ; 90 patients in group B were treated with modified minimally invasive hematoma evacuation. All the patients were followed up for 1 year, Comparisons were made between the two groups on operation time, the incidence of postoperative bleeding, mortality, neurological deficit scores of survival patients and the Barthel index of activities of daily living （ADL） scale score. Results The mean operating time of group A was（55.2±3.4）min, The mean operating time of group B was（40.3 ± 3.2）min, There were significant difference between the two groups; Bween A and B groups, the rate of postoperative rebleeding（22.7% and23.3%）, postoperative mortality（17.0% and 17.8%）, neurological deficit scores of survival patients, and Barthel Index daily life activities scale score were not significant different within follow-up duration. Conclusion The modified minimally invasive hematoma evacuation can significantly reduce operation time and the postoperative mortality and rebleeding rate were not increased.The recent neurological deficits and long-term efficacy （activities of daily living） were not significant different.

关 键 词：基底节脑出血 微创穿刺术 改良 疗效 

分 类 号：R743.34[医药卫生—神经病学与精神病学]