自制激光辅助立体定向头架置管治疗壳核出血的疗效研究  

Effect of self-made laser assisted stereotactic head frame on putaminal hemorrhage

作　　者：白杨[1] 王东[2] 苏醒[1] 周志中[1] 

机构地区：[1]吉林市中心医院(吉林大学吉林医院)神经外科,132000 [2]广州军区广州总医院神经外,广州510010

出　　处：《中华神经医学杂志》2015年第11期1156-1158,共3页Chinese Journal of Neuromedicine

基　　金：吉林市科技计划项目（201437053）

摘　　要：目的探讨自制激光辅助立体定向头架行血肿腔穿刺置管治疗高血压脑出血的效果。方法对吉林市中心医院神经外科自2013年1月1日至2014年1月1日收治的67例壳核出血患者应用自制激光辅助立体定向头架行颅内血肿腔穿刺置管治疗（微创组），并以采用传统开颅手术方式治疗的53例同期壳核出血患者为对照（传统开颅组），对2组患者的手术效果进行系统分析和评价。结果微创组患者与传统开颅组患者比较，术后6个月内死亡率明显降低f8．9％＂s22．6％）、再出血率明显降低（2．99％ vs 15．1％）、6个月良好率明显升高（68．7％vs 543．4％）、平均手术时间明显缩短[（41．2±8．1）min vs（203．2±38．6）min]、平均住院时间明显缩短[（18．2±4．4）d vs（28．1±7．2）d]、平均住院费用明显减少[（23647．7±5503．2）元vs（51678．6±7524．2）元1，差异均有统计学意义（P〈0．05）。结论采用自制激光辅助立体定向头架进行颅内血肿腔穿刺置管治疗壳核出血操作简便、费用低廉、效果良好。Objective To study the effect of self-made stereotactic head frame on hypertensive cerebral hemorrhage. Methods Sixty-seven patients with putamen hemorrhage, admitted to our hospital from January 1, 2013 to January 1, 2014, were enrolled as minimally invasive group; a self-made laser assisted stereotactic head frame was used to putaminal intracranial catheter. Another 53 patients with putaminal hemorrhage, performed traditional craniotomy at the same time period, were enrolled as control group. Systemic analysis and evaluation of effect of these two methods were performed. Results As compared with the control group, minimally invasive group had significantly lower mortality rate 6 months after surgery （22.6% vs. 8.9%） and re-bleeding rate （15.1% vs. 2.99%）, significantly increased percentage of favorable outcomes （43.4% vs. 68.7%）, statistically shorter surgical times （[203.2±38.6] min vs. [41.2±8.1] min） and hospital stays （[28.1±7.2] d vs. [18.2±4.4] d）, and significantly decreased medical expenses （[23647.7±5503.2] yuan vs. [51678.6±7524.2] yuan,（P〈0.05）. Conclusion Treating putaminal hemorrhage using self-made laser assisted stereotactic head frame enjoys advantages as simple operation, lower cost and good efficacy.

关 键 词：高血压脑出血 壳核出血 激光辅助 穿刺置管 开颅手术 

分 类 号：R743.34[医药卫生—神经病学与精神病学]