立体定向微创治疗少量高血压基底节区脑出血临床研究  

Treatment of little hypertensive cerebral hemorrhage of basal ganglia region by stereotactic puncture and drainage

作　　者：朱红玉[1] 孟文博[1] 程月飞[1] 王鹏[1] 殷尚炯[1] 赵佩林[1] 王洪生[1] 

机构地区：[1]解放军第二五一医院神经外科,张家口075000

出　　处：《中华神经创伤外科电子杂志》2017年第1期7-11,共5页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

摘　　要：目的探讨CT引导下立体定向微创引流术治疗少量高血压基底节区脑出血的临床疗效。方法选取自2013年1月至2015年12月解放军第二五一医院收治的高血压基底节区脑出血110例患者,出血量20~30 ml,按照随机数字表法将其分为立体定向微创治疗组和保守治疗组各55例。立体定向微创治疗组在CT引导下行立体定向微创引流术,术后血肿腔内注入尿激酶溶解清除血肿;保守治疗组仅给予内科药物治疗。结果立体定向微创治疗组的血肿排空时间(5.40±0.87)d,明显低于保守治疗组的血肿排空时间(22.07±2.79)d,差异有统计学意义(P=0.001);立体定向微创治疗组的住院时间(19.35±3.67)d明显短于保守治疗组的住院时间(23.26±2.80)d,差异具有统计学意义(P<0.05);治疗6个月后的日常生活能力分级,立体定向微创治疗组(日常生活能力优良率81.82%)明显优于保守治疗组(日常生活能力优良率58.18%),差异具有统计学意义(P<0.05)。结论立体定向微创引流术治疗少量高血压基底节区脑出血创伤小、疗效好、安全性高、治疗时间短,可早期解除对重要神经结构的压迫、减轻继发性损害,促进神经功能恢复,值得临床推广应用。Objective To investigate the therapeutic effect of CT-guided stereotactic minimal invasive drainage for little hypertensive cerebral hemorrhage of basal ganglia region. Methods One hundred and ten patients with little hypertensive cerebral hemorrhage of basal ganglia region which hospitalized in 251 hospital of PLA from January 2013 to December 2015 were selected, the amount of bleeding was 20-30 ml, divided into the operation treatment group and conservative treatment group according to the random number table method, 55 patients in each group. The operation treatment group was given CT-guided stereotactic minimal invasive and drainage treatment, after operation, poured urokinase into the hematoma to dissolved it. The conservative treatment group was given internal medicine treatment alone. Results The emptying time of hematoma of the operation treatment group [（5.40±0.87） d] was significantly shorter than the conservative treatment group[（22.07±2.79） d] （P=0.001）. The average hospitalization days of the operation treatment group [（19.35 ±3.67） d] was significantly shorter than the conservative treatment group [（23.26±2.80） d]（P〈0.05）. The ADL classification of the operation treatment group （81.82%） which six months after treatment was excelled than the conservative treatment group （58.18%）（P〈0.05）. Conclusion Thestereotactic minimal invasive and drainage for little hypertensive cerebral hemorrhage of basal ganglia region were effective, with little injury, shorter hospitalization, supernal security, which can relieved the stress to important nerval tissue and ease the progressive injury and promote rehabilitation of function in the early. Thestereotactic minimal invasive and drainage for little hypertensive cerebral hemorrhage of basal ganglia region is worthy for the clinical popularization and application.

关 键 词：脑出血 高血压 基底节 立体定向 

分 类 号：R651.12[医药卫生—外科学]