神经导航精准定位微创治疗中小量高血压性基底节脑出血  

Minimally invasive therapy for hypertensive cerebral hemorrhage in basal ganglia under neural navigation-assisted precise position

作　　者：龚良[1] 钱忠心[1] 刘卫东[1] 赵鸿[1] 赵明珠[1] 

机构地区：[1]上海市浦南医院神经外科,上海200125

出　　处：《兰州大学学报（医学版）》2016年第5期36-39,共4页Journal of Lanzhou University（Medical Sciences）

基　　金：上海市医学重点专科建设(神经外科)项目(ZK2015A12)

摘　　要：目的 探讨神经导航下经额穿刺血肿微创治疗高血压性脑出血的疗效。方法 对32例伴有明显肢体活动障碍的高血压性基底节区脑出血患者,选择血肿侧距离眉间8~10 cm、旁开中线2~3.5 cm为穿刺点,根据CT影像资料采用神经导航辅助下经额部穿刺抽吸血肿。与同期28例保守治疗患者进行比较,观察两组肢体功能障碍的变化及总体疗效。结果 两组病例均无死亡,微创治疗组治疗2周后肢体瘫痪改善率明显高于保守治疗组（P〈0.05）,3个月后进行临床预后评价,微创治疗组功能恢复优于保守治疗组（P〈0.05）。结论 神经导航引导经额穿刺血肿微创治疗高血压性基底节区脑出血能显著改善血肿对神经结构的损伤,提高疗效。Objective To investigate the effect of neuro-navigation transfrontal puncture on the therapy for hypertensive cerebral hemorrhage in basal ganglia. Methods 32 patients with limb movement inability from hypertensive cerebral hemorrhage of basal ganglia in Shanghai Punan Hospital from 2009.6-2014.6 received minimally invasive puncture drainage under navigation guidance. The puncture site was located in the frontal region 8 - 10 cm at distance ofglabellum on the hemorrhage side and adjacent to the midline 2 -3.5 cm. The hematoma was drainaged by neuro-navigation assisted frontal puncture according to the CT image, And compared the difference in the change as well as the overall effect of limb dysfunction between operation group and 28 cases of non-operation patients. Results No death was found in two groups. Early （2 weeks） improvement rate of limbs paralysis in minimally invasive therapy group was significantly higher than that of non-operation group （P 〈 0.05）. The clinical prognosis and surgical curative effect in minimally invasive therapy group were significantly better than those in non-operation group after three month （P 〈 0.01）. Conclusion Minimally invasive therapy for hypertensive cerebral hemorrhage in basal ganglia under neural navigation can significantly improve the damage ofhemotoma to the nerve structure and improve the curative effect.

关 键 词：高血压 脑出血 神经导航 经额穿刺 

分 类 号：R743.3[医药卫生—神经病学与精神病学]