微创钻孔软通道穿刺置管引流术治疗丘脑出血破入脑室的效果分析  

Minimally Invasive Drilling Soft Channel Puncture and Catheter Drainage for the Treatment of Thalamic Hemorrhage Breaking Into the Ventricle

作　　者：张红彬[1] 朱振云[1] 梁建锋[1] 李志强[1] 韩磊[1] ZHANG Hongbin;ZHU Zhenyun;LIANG Jianfeng;LI Zhiqiang;HAN Lei(Department of Neurosurgery,The First Hospital of Fangshan District,Beijing 102400,China)

机构地区：[1]北京市房山区第一医院神经外科,北京102400

出　　处：《中国继续医学教育》2018年第18期94-96,共3页China Continuing Medical Education

摘　　要：目的探讨微创钻孔软通道穿刺置管引流术治疗丘脑出血破入脑室的临床效果。方法选取我院2011年1月—2015年1月收治入院的采用微创钻孔软通道穿刺置管引流术治疗丘脑出血破入脑室系统的100例患者作为观察组。另选择我院同期收治入院的丘脑出血破入脑室实施传统开颅手术治疗患者100例作为对照组,比较两组患者的临床疗效。结果观察组患者术后血肿清除时间、平均手术时间短于对照组,且组间比较,差异有统计学意义(P<0.05);观察组再出血率、1个月病死率低于对照组,且组间比较,差异有统计学意义(P<0.05);两组患者颅内感染率比较,差异无统计学意义(P>0.05);观察组手术后1个月、术后6个月Barthel指数评分均高于术前、术后1周及对照组同时间段,且组间比较,差异有统计学意义(P<0.05)。结论微创钻孔软通道穿刺置管引流术治疗丘脑出血破入脑室,血肿清除时间缩短,死亡率降低。该术式简单,快捷治愈相对较高,是治疗丘脑出血破入脑室的有效方法。Objective To explore the clinical effect of minimally invasive drilling soft channel puncture and cannulation for thalamic hemorrhage breaking into the ventricles. Methods A total of 100 patients admitted to the hospital from January 2011 to January 2015 were treated with minimally invasive drilling soft channel puncture catheterization to treat thalamic hemorrhage and ruptured into the ventricular system as observation group. In addition, 100 patients with thalamotosis admitted to our hospital who were admitted to the hospital during the same period were treated with conventional craniotomy as a control group. Clinical efficacy of the two groups was compared. Results The postoperative hematoma clearance time and average operation time were significantly shorter in the observation group than in the control group, and the difference was statistically significant（P〈0.05）. The rebleeding rate and mortality rate in the observation group were significantly lower than the control group. There was a statistically significant difference between the two groups（P〈0.05）. There was no significant difference in the intracranial infection rate between the two groups（P〈0.05）. The Barthel index scores were significant in the observation group at 1 month and 6 months after operation. The difference was statistically significant（P〈0.05）. The difference was statistically significant between preoperative and postoperative 1 week, compared with control group. Conclusion The minimally invasive drilling soft channel puncture and catheter drainage is used to treat thalamic hemorrhage and break into the ventricles. The time for hematoma removal is shortened and the mortality rate is reduced. The operation is simple, quick and relatively high cure, is an effective method to treat thalamic hemorrhage into the ventricle.

关 键 词：丘脑出血破入脑室 血肿腔 侧脑室 钻孔外引流 尿激酶 

分 类 号：R651[医药卫生—外科学]