立体定向软通道与硬通道微创血肿清除术治疗脑出血临床效果比较  

Comparison of clinical effects of stereotactic soft channel/hard channel minimally invasive hematoma evacuation in the treatment of cerebral hemorrhage

作　　者：祝亮 张昊淼 张显 魏强 ZHU Liang;ZHANG Haomiao;ZHANG Xian;WEI Qiang(Central Hospital of Yongcheng ,Yongcheng 476600 ,Chin)

机构地区：[1]永城市中心医院,河南永城476600

出　　处：《中国实用神经疾病杂志》2018年第9期987-991,共5页Chinese Journal of Practical Nervous Diseases

摘　　要：目的比较立体定向软通道与硬通道微创血肿清除术治疗高血压脑出血的临床效果。方法选择2014-03—2017-03在永城市中心医院住院治疗的116例高血压脑出血患者为研究对象,2组均行微创血肿清除术,其中60例患者行立体定向软通道微创血肿清除术(软通道组),56例行立体定向硬通道微创血肿清除术(硬通道组),观察并比较2组患者不同时间点的血肿量及术后并发症;术后均随访6个月,统计生存率及日常生活能力。结果经统计分析,术前2组患者血肿量、日常生活能力评分(ADL)对比无差异;术后2组患者血肿量均显著下降,ADL评分显著升高,软通道组各时间节点的血肿量、ADL评分均高于硬通道组,对比差异有统计学意义(P<0.05)。且软通道组术后并发症发生率仅为1.67%,硬通道组为10.71%;软通道组术后6个月随访时生存率86.67%,硬通道组生存率71.43%,差异均有统计学意义(P<0.05)。结论立体定向软通道/硬通道微创血肿清除术治疗高血压脑出血患者均能取得一定疗效,但软通道微创血肿清除术患者术后并发症相对较少,预后情况较硬通道微创血肿清除术略有优势。Objective To compare the clinical effects of minimally invasive hematoma evacuation with stereotactic soft channel and hard channel in the treatment of hypertensive intracerebral hemorrhage.Methods 116 patients with hypertensive intracerebral hemorrhage treated in our hospital from March 2014 to March 2017 were selected for the study and all given minimally invasive hematoma evacuation.Among them,60 patients were treated with stereotactic soft channel minimally invasive hematoma evacuation（the soft channel group）and other 56 cases were given stereotactic hard channel minimally invasive hematoma evacuation（the hard channel group）.compared the hematoma volume at different time pointsand the postoperative complications.all patients were followed up 6 months,and recordedsurvival rate and activities of daily living.Results According to the statistical analysis,there were no difference in the hematoma volume and daily life ability score（ADL）between in the two groups.The hematoma volume decreased significantly while the ADL score significantly increased in both groups,and the hematoma volume and ADL score of the soft channel group were significantly higher than those of the hard channel group（P0.05）.The incidence rate of postoperative complications in the soft channel group was only 1.67%,which was less than that in the hard channel group with10.71%.The survival rate was 86.67%in the soft channel group at 6 months follow-up,which was higher than that of the hard channel group with 71.43%,and the difference was statistically significant（P0.05）.Conclusion Stereotactic soft channel/hard channel minimally invasive hematoma evacuation can achieve a certain effect in the treatment of patients with hypertensive intracerebral hemorrhage,but there are relatively small postoperative complications and a slight advantage in the prognosis in the soft channel minimally invasive hematoma evacuation.

关 键 词：立体定向软通道 硬通道 微创血肿清除术 高血压 脑出血 

分 类 号：R743.34[医药卫生—神经病学与精神病学]