无框架立体定向机器人治疗高血压脑出血的应用研究  

Application of frameless stereotactic aspiration in the treatment of hypertension cerebral hemorrhage

作　　者：张友三[1] 程岗 范磊[1] 王睿勤[1] 刘帅 张剑宁 

机构地区：[1]渑池县人民医院神经外科,河南渑池472400 [2]北京海军总医院神经外科,100048

出　　处：《解放军医学杂志》2016年第8期673-676,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨无框架立体定向机器人穿刺外引流治疗高血压脑出血的技术要点和临床效果。方法回顾性分析2012年1月—2014年6月采用无框架立体定向机器人治疗的68例高血压脑出血患者的临床资料,并与同期采用有框架立体定向穿刺抽吸治疗的45例患者进行对比,对手术结果、并发症和临床预后进行分析。结果无框架立体定向机器人治疗患者的平均年龄为53.3（36-80）岁,术前格拉斯哥评分均〉5分。术后1个月内死亡7例,其中肺部感染3例、脑水肿2例、再出血2例。术后6个月恢复良好率（ADLⅠ-Ⅲ级）为77.9%（53/68）,疗效优于有框架立体定向穿刺抽吸术（术后6个月恢复良好率为60.0%,P〈0.05）。结论运用无框架立体定向机器人治疗高血压脑出血具有操作简单、侵袭性小、手术定位准确、治疗效果确切、安全有效等优点,值得临床推广。Objective To investigate the technical points and clinical outcomes of frameless stereotactic aspiration in treatment of patients with hypertension cerebral hemorrhage（HPCH）. Methods The clinical data of 68 consecutive patients with HPCH, treated with frameless stereotactic aspiration from Jan. 2012 to Jun. 2014, were retrospectively analyzed, and compared to that of 45 patients treated in the meantime by frame-based stereotactic aspiration. The surgical results, procedure-related complications and clinical prognosis were evaluated. Results For the patients treated with frameless stereotactic aspiration, the median age was 53.3 years（range 36-80）, the mean initial Glasgow coma scale score was over 5. Among them seven patients died within a month after operation： 3 died of respiratory failure, 2 of cerebral edema and 2 of rehemorrhage. At the six-months followup, the good recovery rate（gradeⅠ-Ⅲ of ADL） was 77.9%（53/68）, better than that of patients treated with frame-based stereotactic aspiration（60.0%, P〈0.05）. Conclusion Frameless stereotactic aspiration for HPCH is easy to operate, minimal invasion and safe procedure with low mortality and rehemorrhage rate.

关 键 词：颅内出血 高血压性 立体定位技术 治疗结果 

分 类 号：R743.205[医药卫生—神经病学与精神病学]