单双管微创穿刺引流术治疗大量基底节区高血压脑出血的疗效比较  

Comparison of the efficacy of minimally invasive stereotactic puncture and drainage of single and double tube in patients with massive hypertensive intracerebral hemorrhage in the basal ganglia

作　　者：常鹏飞[1] 邬巍[1] 左程[1] 鲁质成[1] 王长坤[1] 綦斌[1] 

机构地区：[1]吉林大学第一医院神经外科,长春130021

出　　处：《中华实验外科杂志》2015年第9期2258-2260,共3页Chinese Journal of Experimental Surgery

摘　　要：目的 对比微创立体定向单管穿刺与双管穿刺引流术治疗大量基底节区高血压脑出血疗效差异.方法 回顾分析高血压脑出血行单管穿刺引流术100例和行双管穿刺引流术50例患者的临床资料,对血肿清除率、引流管时间、尿激酶注人次数、ICU住院时间、颅内感染率、日常生活能力（ADL）评分进行统计学分析.结果 单管组血肿清除率为（89.50±1.89）％,双管组为（93.50±2.36）％,两组差异有统计学意义（P＜0.05）;单管引流时间（5.31±1.86）d,双管引流时间（3.15±1.81）d,差异有统计学意义（P＜0.01）;单管组注入尿激酶（5.31±1.23）次,双管组注入尿激酶（3.31±1.68）次,两组比较差异有统计学意义（P＜0.05）;单管组ICU住院时间（7.36±2.45）d,双管组ICU住院时间（5.31±1.23）d,差异有统计学意义（P＜0.05）;单管组颅内感染率为8％,双管组颅内感染率为4％,差异有统计学意义（P＜0.01）;单管组穿刺道出血率为0％,双管组穿刺道出血率为6％,差异有统计学意义（P＜0.01）;按ADL分级法评价患者预后：单管组Ⅰ级10例,Ⅱ级25例,Ⅲ级30例,Ⅳ级30例,Ⅴ级5例;双管组Ⅰ级7例,Ⅱ级15例,Ⅲ级20例,Ⅳ级6例,Ⅴ级2例,两组差异有统计学意义（P＜0.05）.结论 双管较单管穿刺引流具有血肿清除率高、尿激酶注入次数少、引流时间短、ICU住院时间短、颅内感染率低的优点,但穿刺道出血率较高.Objective To investigate the efficacy of the minimally invasive stereotactic puncture and drainage of single and double tube for massive hypertensive intracerebral hemorrhage （ICH） in the basal ganglia.Methods A retrospective study of patients who had hypertensive ICH in the basal ganglia and underwent surgical treatment was conducted,including 100 patients with single tube drainage and 50 patients with double tube drainage.The clearance rate of hematoma,drainage tube indwelling time,urokinase injection times,ICU length of stay,intracranial infection rate,and activities of daily living （ADL） scores were statistically analyzed.Results The hematoma clearance rate was （89.50 ± 1.89） ％ in single tube group,and （93.50 ± 2.36） ％ in double tube group with the difference being statistically significant between two groups （P ＜ 0.05）.The drainage tube indwelling time was （5.31 ± 1.86） days in single tube group,and （3.15 ± 1.81） days in double tube group with the difference being statistically significant between two groups （P ＜ 0.01）.The urokinase injection times were （5.31 ± 1.23） in single tube group,and （3.31 ± 1.68） in double tube group with the difference being statistically significant between the two groups （P ＜ 0.05）.The ICU length of stay was （5.31 ± 1.23） days in double tube group,and （7.36 ± 2.45） days in single tube group with the difference being statistically significant （P ＜ 0.05）.The intracranial infection rate was 4％ in double tube group,and 8％ in single tube group with the difference being statistically significant between the two groups （P ＜ 0.01）.The channel bleeding rate was 6％ in double tube group,and 0％ in single tube group with the difference being statistically significant between the two groups （P ＜0.01）.According to ADL scores to assess the prognosis,there were 10 cases of stage Ⅰ,25 cases of stage Ⅱ,30 cases of stage Ⅲ,30 cases of stage Ⅳ,and 5 cases of stage Ⅴ in single tube group,and there

关 键 词：高血压脑出血 微创穿刺引流术 

分 类 号：R743.34[医药卫生—神经病学与精神病学]