立体定向软通道颅内血肿清除引流术在颅脑创伤基底节血肿清除中的应用效果  

Application effect of stereotactic soft-channel intracranial hematoma removal and drainage in hematoma removal from basal ganglia of craniocerebral trauma

作　　者：温桂菲 徐龙彪 韦超 冯方军 WEN Guifei;XU Longbiao;WEI Chao;FENG Fangjun(Operating Room,Zhuji People's Hospital in Zhejiang Province,Zhuji 311800,China)

机构地区：[1]浙江省诸暨市人民医院手术室,浙江诸暨311800

出　　处：《中国现代医生》2020年第15期108-111,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2020PY081)。

摘　　要：目的探讨立体定向软通道颅内血肿清除引流术在颅脑创伤基底节血肿清除中的应用效果。方法回顾性分析2017年6月~2019年12月在我院诊断治疗的颅脑创伤后基底节出血患者60例的临床资料,其中30例患者采用立体定向软通道颅内血肿清除引流术治疗为观察组,30例患者采用小骨窗开颅术治疗为对照组,比较两组的手术时间、术后住院时间、复发率;比较两组治疗后1、3个月NIHSS评分与Barthel指数;比较两组治疗后3个月GOS评价。结果(1)治疗后1个月、3个月,两组NIHSS评分均低于治疗前,差异有统计学意义(P<0.05);治疗后1、3个月,观察组NIHSS评分低于对照组,差异有统计学意义(P<0.05)。(2)观察组手术时间较对照组短,术后住院时间较对照组短,差异有统计学意义(P<0.05);两组均有1例血肿复发,差异无统计学意义(P>0.05)。(3)治疗后1个月、3个月,两组Barthel指数均显著高于治疗前,差异有统计学意义(P<0.05);治疗后1个月、3个月,观察组Barthel指数显著高于对照组,差异有统计学意义(P<0.05)。(4)秩和检验显示,观察组治疗后3个月GOS评价预后显著优于对照组,差异有统计学意义(P<0.05)。结论立体定向软通道颅内血肿清除引流术治疗颅脑创伤患者基底节血肿具有创伤小,定位准确,效果好等优点。Objective To investigate the application effect of stereotactic soft-channel intracranial hematoma removal and drainage in the removal of hematomas in basal ganglia of craniocerebral trauma.Methods The clinical data of 60 patients with basal ganglia hemorrhage after traumatic brain diagnosed and treated in the hospital from June 2017 to December 2019 were retrospectively analyzed.30 patients were enrolled as the observation group treated with stereotactic soft-channel intracranial hematoma removal and drainage,and 30 patients were enrolled as the control group treated with small bone window craniotomy.The operation time,postoperative hospital stay,and recurrence rate were compared between the two groups.The NIHSS score and Barthel index were compared between two groups at 1 and 3 months after treatment.GOS evaluation was compared 3 months after treatment between the two groups.Results(1)At 1 and 3 months after treatment,the NIHSS scores of the two groups were lower than those before treatment,and the difference was statistically significant(P<0.05).At 1 and 3 months after treatment,the NIHSS score of the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).(2)The operation time in the observation group was shorter than that in the control group,and the length of postoperative hospital stay was shorter than that in the control group,with statistically significant difference(P<0.05).There was one case of hematoma recurrence in both groups,without statistically significant difference(P>0.05).(3)At 1 and 3 months after treatment,the Barthel index of the two groups was significantly higher than that before treatment,and the difference was statistically significant(P<0.05).The Barthel index of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).(4)The rank sum test showed that the prognosis of GOS evaluation in the observation group at 3 months after treatment was significant

关 键 词：立体定向软通道颅内血肿清除引流术 颅脑创伤 基底节血肿 

分 类 号：R651.12[医药卫生—外科学]