帕金森病外科治疗并发单纯性基底节血肿的临床研究(附16例单纯性基底节血肿的预后分析)  

Clinical investigation on the simple hemorrhage following surgerical treatment for Parkinson disease (prognosis analysis of 16 cases with simple hemorrhage)

作　　者：徐强[1] 张世忠[1] 徐如祥[1] 张旺明[1] 

机构地区：[1]第一军医大学珠江医院神经外科,广东广州510282

出　　处：《中风与神经疾病杂志》2002年第5期294-296,共3页Journal of Apoplexy and Nervous Diseases

摘　　要：目的　探讨微电极导向立体定向手术治疗帕金森病并发基底节血肿发生的原因和有效防治措施。方法　对行微电极导向立体定向术的 6 12例帕金森病患者中术后并发基底节血肿的 16例 (2 .6 % )患者进行总结和分析。结果　术中毁损灶出血 16例 ,其中 9例血肿体积小于 5 ml,保守治疗 ,3个月后复查头部 CT,术区损毁灶明显 ,对侧肢体的僵硬或震颤症状改善明显 ;6例血肿体积 5 m l～ 2 0 m l之间 ,行血肿抽吸术 ,术后对侧肢体肌力下降为 III～ IV级 ;开颅血肿清除术 1例 ,术后对侧肢体偏瘫明显。本组病例血肿发生率为 2 .6 % ,术后 3个月治愈率为 81.2 %。结论　微电极导向立体定向治疗帕金森病可以提高疗效 ,减少并发症的发生 ,但有引起术区出血的可能 ,而立体定向血肿抽吸术为血肿清除提供了有效的治疗手段。Objective To study the cause and the effective prevention and cure of the complication with surgerical treatment for Parkinson disease -hemorrhage in basal nucleus. Methods According to the prognosis of 16 cases with simple basal nucleus hemorrhage among 612 Parkinson disease patients after microelectrode guided stereotaxic operation,summary and analyse the curative effect of keeping,stereotaxic technique hematoma suction and operation. Results Among 16 cases,9 cases whose hematoma were less than 5ml were carried out keeping therapy and had no deformity. 6 cases,5～20ml,were carried out stereotaxic technique hematoma suction and left behind slight paralysis,not left over abnormality sign. One case,25ml,were carried out operation and left over hemiplegia. So the incidence of hematoma was 2.6%,the fully preclude rate of the complication three months after operation was 81.2%. Conclusion Microelectrode guided stereotaxic technique for Parkinson disease can effectively promote the therapy effect and reduce the complication,but can induce bleeding in operative area. Stereotaxic technique hematoma suction can provide an effective therapeutic method.

关 键 词：治疗 单纯性基底节血肿 帕金森病 立体定向血肿抽吸术 并发症 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R651.[医药卫生—临床医学]