立体定向手术结合侧脑室钻孔引流术对继发性脑室出血的疗效比较  

Therapeutic effects of stereotactic surgery combined with lateral ventricle trepanation and drainage as well as open craniotomy combined with lateral ventricle trepanation and drainage on secondary intraventricular hemorrhage

作　　者：田恒超 TIAN Hengchao(Department of Neurosurgery,People’s Hospital of Chengwu County,Shandong,Chengwu 274200,China)

机构地区：[1]山东省成武县人民医院神经外科,274200

出　　处：《河北医药》2018年第6期874-877,881,共5页Hebei Medical Journal

摘　　要：目的对继发性脑室出血(SIH)应用不同术式联合侧脑室钻孔引流术的近远期疗效比较。方法选择73例符合手术指征的SIH患者入组,按术式选择不同分为试验组(n=32)与对照组(n=41),分别实施立体定向手术与开颅手术结合侧脑室钻孔引流术治疗,回顾性分析2组近远期疗效。结果术后1个月内试验组发生并发症发生率与病死率比较对照组少,试验组术后1个月血肿清除效果、清除率高于对照组,但组间差异均无统计学意义(P>0.05)。术后1个月日常生活活动量评价显示,试验组生活完全能够自理及基本能够自理者所占比例明显高于对照组(P<0.05)。术后6~12个月预后情况评价发现,试验组恢复良好,生活能自理者所占比例要明显多于对照组(P<0.05)。结论与开颅手术引流相比,立体定向手术结合侧脑室钻孔引流术对脑室出血患者的血肿清除效果显著,且手术创伤小,患者术后自我恢复能力强,长期预后更佳。Objective To compare the short-term and long-term curative effects of different surgical modes combined with lateral ventricle trepanation and drainage on secondary intraventricular hemorrhage(SIH).Methods A total of 73 patients with SIH were divided into two groups according to different operation methods:experimental group(n=32)and controlled group(n=41).The patients in experimental group were treated by stereotactic surgery combined with lateral ventricle trepanation and drainage,however,the patients in control group were treated by open craniotomy combined with lateral ventricle trepanation and drainage.The short-term and long-term curative effects were retrospectively analyzed and compared between two groups.Results The incidence rate of complications and death rate within 1 month after operation in experimental group were lower than those in control group,however,the removal rate of hematoma in experimental group was higher than that in control group,but there was no significant difference between the two groups(P>0.05).The proportion of patients who could take care of themselves completely in experimental group was significantly higher than that in control group(P<0.05).The prognosis evaluation results showed that patient’s recovery after 6~12 months in experimental group was good,moreover,the proportion of patients who could take care of themselves completely in experimental group was significantly higher than that in control group(P<0.05).Conclusion As compared with open craniotomy,the effects of stereotactic surgery combined with lateral ventricle drainage on hematoma evacuation are significant,which has the advantages of little surgical trauma,good postoperative recovery ability and satisfactory long-term prognosis.

关 键 词：继发性脑室出血 立体定向术 开颅手术 侧脑室钻孔引流 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]