立体定向微创钻孔引流与保守治疗未昏迷的基底节区出血患者的疗效对比  

Comparative study on stereotactic microimpact burr-hole drainage and conservative treatment for conscious patients of hypertensive cerebral hemorrhage in basal ganglia area

作　　者：刘海兵[1] 魏梁锋[1] 赵琳[1] 王守森[1] 洪景芳[1] LIU Hai-bing;WEI Liang-feng;ZHAO Lin(Department of Neurosurgery, Fuzhou General Hospital of Nanjing Military Command, Fuzhou 350025, Chin)

机构地区：[1]南京军区福州总医院神经外科,福州350025

出　　处：《临床神经外科杂志》2018年第1期38-41,45,共5页Journal of Clinical Neurosurgery

基　　金：福州总医院临床应用研究专项(2016L16)

摘　　要：目的研究未昏迷基底节区高血压脑出血患者立体定向微创钻孔引流手术治疗与内科保守治疗的疗效。方法分析116例未昏迷的基底节区高血压脑出血患者的临床资料;其中74例患者采用立体定向钻孔引流手术治疗(微创手术组),42例患者采用内科保守治疗(保守治疗组)。对比两组患者的治疗效果和预后。结果微创手术组患者基底节区血肿的消除时间明显短于保守治疗组。治疗2周后,微创手术组血肿清除≥95%的患者的比率(97.3%)显著高于保守治疗组(47.6%),患侧肢体肌力改善亦显著优于保守治疗组,差异均有统计学意义(χ~2=40.297,Z=5.617,均P<0.001)。结论对有手术指征的未昏迷基底节区脑出血患者,立体定向钻孔引流手术的治疗效果显著优于内科保守治疗;能明显改善患者的神经功能及预后。Object To study the therapeutic effects of stereotactic microimpact burr-hole drainage and conservative treatment for conscious patients of hypertensive cerebral hemorrhage in basal ganglia area. Methods The clinical data of 116 conscious patients with hypertensive cerebral hemorrhage in basal ganglia area from October 2013 to October 2016 were analyed retrospectively. Of116 patients,74 were treated with stereotactic microimpact burr-hole drainage with instillation of urokinase,and 42 received conservation treatment. compared between the two groups of the prognosis effect and 6 months follow-up recovery. Results In stereotactic group,the dissipation time of hematoma was significantly shorter（ P 0. 05）. 14 days of limb muscle recovery and 90 days Glasgow outcome scale score were significantly better than that of the conservative treatment group（ all P 0. 05）. Conclusion The therapeultic effect of stereotactic microimpact burr-hole drainage was significantly superior to the conservative treatment in conscious patients of hypertensive cerebral hemorrhage in basal ganglia area. It improves limb muscle recovery and worthy of clinical use.

关 键 词：高血压脑出血 未昏迷 基底节区 立体定向手术治疗 内科保守治疗 

分 类 号：R651.1[医药卫生—外科学]