微创穿刺引流术治疗基底节区高血压脑出血对水肿带变化的影响  

Effect of minimally invasive puncture and drainage on the changes of edema belt of cerebral hemorrhage in basal ganglion

作　　者：曹栓柱 王艳州 李金泉 田勇 牛海涛 邢晓峰 

机构地区：[1]河北沧州市中心医脑科医院神经外四科,沧州061001 [2]河北泊头市医院脑外科,泊头062150

出　　处：《中国实用神经疾病杂志》2015年第21期4-6,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨微创穿刺引流术用于基底节区高血压脑出血患者对水肿带变化的影响。方法我院2011-03-2014-08收治的97例高血压基底节区脑出血患者,随机分为A、B 2组,其中A组51例,在内科保守治疗的基础上行微创穿刺引流术;B组46例,仅采用内科保守治疗。比较2组水肿带、血肿清除率、神经功能恢复情况、mRS评分及病死率。结果与术前比较,术后A组水肿带明显减小,B组水肿带逐渐变大,第5天达到峰值;与B组相比,A组在第1、3、5、7天均较低(P<0.01)。治疗3周后,与B组比较,A组血肿清除率较高且神经功能缺损评分较低。治疗3个月后,与B组比较,A组mRS评分等级较优(P<0.05)。2组病死率差异无统计学意义(P>0.05)。结论微创穿刺引流术治疗基底节区脑出血血肿清除率高、手术创伤小,能显著改善脑组织水肿,对促进患者神经功能恢复,提高患者生存质量有重大意义。Objective To observe the effect of minimally invasive puncture and drainage on the changes of edema belt of cerebral hemorrhage in basal ganglion region.Methods 97 cases with cerebral hemorrhage in basal ganglion from March 2011 to August 2014 in our hospital were selected and randomly divided into group A and group B.51 cases in group A were treated by minimally invasive puncture and drainage based on conventional therapy and 46 cases in group B received conventional thera‐py.The changes of edema belt of cerebral hemorrhage ,clearance rate of hematoma ,the condition of neurological function recov‐ery ,mRS scores and mortality were compared between the two groups .Results Compared with pre‐operation ,the edema belt of cerebral hemorrhage in group A decreased obviously ,which in group B increased remarkably and peaked on the 5th day after operation ,which on 1st ,3rd ,5th and 7th day in group A reminded lower levels compared with group B （P〈0.01）.After 3‐week treatment ,the group A had significantly higher the clearance rate of hematoma and lower scores of neural function defect scale than group B.In addition ,the scores of mRS were lower in group A after 3 months treatment than that in group B （P〈0.05 ） ,the mortality between two groups displayed no significant difference （P〉0.05）.Conclusion The treatment of mini‐mally invasive puncture and drainage has higher clearance rate of hematoma and less surgical trauma in cerebral hemorrhage pa‐tients in basal ganglion ,which can promote the recovery of neurological function and improve the quality of life.

关 键 词：微创穿刺引流术 脑出血 水肿带 基底节 

分 类 号：R743.34[医药卫生—神经病学与精神病学]