立体定向微创引流术治疗高血压小脑出血(附23例报告)  

The stereotactic minimally invasive surgical treatment for hypertensive cerebellar hemorrhage(23 cases report)

作　　者：朱红玉[1] 孟文博[1] 程月飞[1] 翟晓东[1] 赵佩林[1] 王洪生[1] Zhu Hongyu Meng Wenbo Cheng Yuefei et al(Department of Neurosurgery , 251 Hospital of PLA , Zhangj iakou, 075000, China)

机构地区：[1]中国人民解放军第251医院神经外科,张家口075000

出　　处：《立体定向和功能性神经外科杂志》2017年第3期169-172,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的探讨CT引导下立体定向微创引流术治疗高血压小脑出血的临床疗效。方法选取2013年1月~2016年6月解放军第251医院收治的46例高血压小脑出血患者,出血量10~20ml,按照随机数字表法将其分为立体定向组和开颅手术组各23例。立体定向组在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;开颅手术组在全麻下行后颅窝开颅,显微镜下清除血肿,术后给予止血、脱水等治疗。结果立体定向组的住院时间明显短于开颅手术组的住院时间(P=0.01);立体定向组的术后并发症低于开颅手术组的术后并发症(P=0.03);立体定向组的血肿排空时间较开颅手术组的血肿排空时间长(P=0.04);治疗6个月后的ADL分级立体定向组与开颅手术组无差异(P=0.33)。结论应用立体定向微创引流术治疗高血压小脑出血可获得与后颅窝开颅术相当的清除效果,且定位准确、创伤小、并发症少、治疗时间短,值得临床推广应用。Objective To investigate the therapeutic effect of CT--guided stereotactic min- imal invasive and drainage for hypertensive cerebellar hemorrhage. Methods 46 patients with hy-pertensive cerebellar hemorrhage which hospitalized in 251 hospital of PLA from January 2013 to Jun 2016 were selected,the amount of bleeding was 10420 ml, they divided into the stereotatie group and craniotomy group according to the random number table method, 23 patients in each group. The stereotatic group was given CT--guided stereotactic minimal invasive and drainage treatment,after operation, poured urokinase into the hematoma to dissolved it. The craniotomy group was performed posterior cranial fossa craniotomy after general anesthesia and the hemo- toma was removaled by the microsurgery, after operation, the hemostasis, dehydyation etc were given to the patients. Results The average hospitalization days of the stereotatic group was significantly shorter than the craniotomy group （P = 0. 01）. The postoperative complication of the stereotatic group less than the craniotomy group（P=0.03）. The emptying time of hematoma of the stereotatic group langer than the craniotomy group（P=0. 04）. The ADL classification after six months treatment of the stereotatic group no statistical difference with the craniotomy group （P=0. 33）. Conclusion The stereotactic minimal invasive and drainage for cerebellar hemorrhage could achieve considerabl reset effect compare with the posterior cranial fossa craniotomy, and it was accurate positioning, little injury,less complication, shorter hospitalization and so on. The ste-reotactic minimal invasive and drainage for hypertensive cerebellar hemorrhage is worthy for the clinical popularization and application.

关 键 词：脑出血 小脑 高血压 立体定向 

分 类 号：R743.34[医药卫生—神经病学与精神病学]