CT引导下微创血肿清除术治疗基底节区自发性脑出血的临床观察  

Clinical Observation of CT-guided Minimally Invasive Evacuation of Hematoma in Treatment of Spontaneous Intracerebral Hemorrhage in Basal Ganglia

作　　者：乔鹏[1] 闫东明[2] QIAO Peng;YAN Dong-ming(Department of Neurosurgery,The First Affiliated Hospital of Henan University of Science and Technology,luoyang 471023,Henan Province,China)

机构地区：[1]河南科技大学第一附属医院神经外科,河南洛阳471023 [2]郑州大学第一附属医院神经外科,河南郑州450000

出　　处：《中国CT和MRI杂志》2018年第6期37-40,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨电子计算机断层扫描(CT)引导下微创血肿清除术治疗基底节区自发性脑出血的应用价值。方法选取102例自发性脑出血患者,依据治疗方法分组分为CT组(n=51)和内科组(n=51),内科组给予内科保守治疗,CT组在内科组治疗基础上给予CT引导下微创血肿清除术,观察两组临床疗效。结果 CT组和内科组的临床总有效率分别为88.24%和72.55%(P﹤0.05),住院期间并发症率分别为5.88%和7.84%(P﹥0.05),随访期间存活率分别为100%和92.16%(P﹤0.05);与治疗前相比,两组治疗后2w、4w的血肿体积逐渐减少(P﹤0.05),组间及组内治疗后不同时间点差异显著(P﹤0.05);与治疗前相比,两组治疗后2w及4w的NIHSS评分逐渐降低、Barthel指数评分逐渐增高(P﹤0.05),组内及组间治疗后不同时间点上述评分差异显著(P﹤0.05)。结论 CT引导下微创血肿清除术具有靶向定位精准、降低术后神经损伤等并发症及死亡风险、血肿清除率高等优点,应用于基底节区自发性脑出血治疗中疗效显著,可有效改善患者神经损伤,利于其日常生活活动能力提高,临床应用价值高。Objective To explore the application values of computed tomography（CT）-guided minimally invasive evacuation of hematoma in the treatment of spontaneous intracerebral hemorrhage in basal ganglia. Methods 102 patients with spontaneous intracerebral hemorrhage were divided into the CT group（n=51） and the internal medicine group（n=51） according to the treatment methods. The internal medicine group was given the internal medicine conservative treatment, and the CT group was given the CT-guided minimally invasive evacuation of hematoma on this basis. The clinical efficacy of the two groups was observed. Results The total effective rates of the CT group and the internal medicine group were 88.24% and 72.55% respectively（P〈0.05）, and the complications rates during hospitalization were 5.88% and 7.84% respectively（P〈0.05）, and the survival rates during follow-up were 100% and 92.16%（P〈0.05）. Compared with before treatment, the hematoma volume was decreased gradually at 2 w and 4 w after treatment（P〈0.05）, and there were significant differences between-groups and withingroups at different time points after treatment（P〈0.05）. Compared with before treatment, the NIHSS score at 2 w and 4 w after treatment was decreased gradually while the Barthel index score was gradually increased（P〈0.05）, and there were significant differences in the above scores between-groups and within-groups at different time points after treatment（P〈0.05）. Conclusion CT-guided minimally invasive evacuation of hematoma has the advantages of precise targeting, reducing risk of postoperative complications and death such as nerve injury, and high hematoma clearance rate. It hs significant efficacy in the treatment of patients with spontaneous intracerebral hemorrhage in basal ganglia, and can effectively improve the nerve injury, and it is conducive to the improvement of their daily living activities, and it has high clinical application values.

关 键 词：电子计算机断层扫描 微创血肿清除术 基底节区自发性脑出血 

分 类 号：R743.34[医药卫生—神经病学与精神病学]