超声在高血压性脑出血微创清除术中的应用  

Application of ultrasound guidance in performing minimally invasive removal of hypertensive intracerebral hemorrhage

作　　者：康慧莉[1] 詹维伟[2] 丁勇[3] 王颖[1] 赵云歆[1] 姚广力[1] 蔡秋琼[1] 梅将军[1] 江怡[1] 

机构地区：[1]上海市浦东新区浦南医院超声科,200125 [2]上海交通大学医学院附属瑞金医院超声科 [3]上海市浦东新区浦南医院神经外科,200125

出　　处：《介入放射学杂志》2016年第1期74-77,共4页Journal of Interventional Radiology

基　　金：上海市浦东新区科技发展基金创新资金(PKJ2012-Y22);浦东新区卫生局重点学科群资助项目(PWZxkq2011-02)

摘　　要：目的探讨超声引导下高血压性脑出血微创清除术的治疗效果和可行性。方法选取2012年8月至2014年12月进行高血压性脑出血治疗的患者60例，随机分为研究组和对照组。研究组30例患者行超声引导下高血压性脑出血微创清除术，对照组30例患者采用常规血肿清除方法。通过观察两组患者的血肿清除率和术后3个月Glasgow预后评分（GOS）分级结果，评价两种治疗方案的效果。结果研究组清除80％以上血肿患者17例，清除70％---80％12例，术中再出血1例：对照组清除80％以上血肿患者10例，清除70％～80％8例，术中再出血12例。研究组血肿清除率明显高于对照组（P〈0．05）。患者术后GOS分级结果表明：研究组恢复良好患者21例，中残4例，重残3例，植物状态1例，死亡1例；对照组恢复良好患者15例，中残8例，重残4例，植物状态2例，死亡1例。研究组术后恢复情况明显优于对照组（P〈0．05）。结论将超声应用于高血压性脑出血微创清除术中提高了血肿清除率，且有更好的术后恢复效果。超声技术为高血压性脑出血的治疗提供了一种新的诊断和治疗技术，可在临床应用中推广。Objective To investigate the therapeutic effect and feasibility of ultrasound-guided minimally invasive removal of hypertensive intracerebral hemorrhage. Methods A total of 60 patients with hypertensive intracerebral hemorrhage, who were treated at authors＇ hospital during the period from August 2012 to December 2014, were enrolled in this study. The patients were randomly divided into the study group （n=30） and the control group （n=30）. Ultrasound-guided minimally invasive removal of hypertensive intracerebral hemorrhage was performed in the patients of the study group, while conventional elimination of hematoma was employed in patients of the control group. Hematoma removal rate and Glasgow Outcome Scale （GOS） scores in both groups were determined at 3 months after the treatment, and the results were evaluated and compared between the two groups. Results In the study group, the bematoma clearance rate over 80% was obtained in 17 patients, and 700/o-80% in 12 patients; and re-bleeding during the procedure was seen in one patient. In the control group, the hematoma clearance rate over 80% was obtained in 10 patients, and 70%-80% in 8 patients; and re-bleeding during the procedure was observed in 12 patients. The hematoma clearance rate of the study group was significantly higher than that of the control group （P〈0.05）. Postoperative GOS scores showed that in the study group good recovery was obtained in 21 patients, moderate disability was seen in 4 patients, severe disability happened in 3 patients, vegetable state was left in one patient, and one patient died; while in the control group good recovery was obtained in 15 patients, moderate disability was seen in 8 patients, sewq＇e disability happened in 4 palients, vegetable slate was left ill 2 patients, and one patient died. The posloperative recovery condition of the study group was significantly better than that of the control group （P〈0.05）. Conclusion HIrasound- guided minimally invasive removal of hyperlensive intracereral hemor

关 键 词：超声 高血压性脑出血 脑血肿 微创清除术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R651.1[医药卫生—诊断学]