立体定向引导下前额锁孔入路神经内镜血肿清除术治疗高血压基底节区脑出血对照研究  

Effect of stereotactic-guided neuroendoscopic haematoma removal via prefrontal keyhole approach in patients with hypertensive basal ganglia intracerebral hemorrhage

作　　者：高波 姚江伟 姬翔 白亚辉[2] Gao Bo;Yao Jiangwei;Ji Xiang;Bai Yahui(First author's address Hebi Coal Industry/Group Limitsd Liability Com pany General Hospital,Hebi 458000,Henan,China)

机构地区：[1]鹤壁煤业(集团)有限责任公司总医院,河南鹤壁458000 [2]郑州大学第一附属医院,河南郑州450000

出　　处：《临床心身疾病杂志》2020年第6期38-40,60,共4页Journal of Clinical Psychosomatic Diseases

摘　　要：目的 探讨立体定向引导下前额锁孔入路神经内镜血肿清除术对高血压基底节区脑出血术后格拉斯哥预后评分及再出血发生率的影响.方法 将74例高血压基底节区脑出血患者按手术方案不同分为对照组、观察组,每组37例.观察组给予立体定向引导下前额锁孔入路神经内镜血肿清除术,对照组给予传统立体定向血肿清除术.比较两组手术时间、术后第1d血肿清除率、术后再出血发生率及并发症发生率,随访6个月统计两组预后情况.结果 观察组手术时间显著长于对照组(P<0.01),术后第1 d血肿清除率显著高于对照组(P<0.01),术后再出血发生率显著低于对照组(P<0.05),并发症发生率显著低于对照组(P<0.05).随访6个月,观察组格拉斯哥预后评分等级显著优于对照组(P<0.01).结论 对高血压基底节区脑出血患者应用立体定向引导下前额锁孔入路神经内镜血肿清除术虽然手术时间较长,但可明显提高血肿清除率,降低术后再出血及并发症发生率,改善预后.Objective To study the effect of stereotactic-guided neuroendoscopic haem atom a removal via prefrontal keyhole approach on Glasgow prognosis(GOS)score and the incidence of rebleeding after operation for hypertensive basal ganglia intracerebral hem orrhage.Methods 74 patients with hypertensive basal ganglia intracerebral hem orrhage were divided into control group(n=37)and observation group(n=37)according to different surgical procedures.The observation group was treated w ith neuroendoscopic hem atom a removal th rough frontal keyhole approach under stereotactic guidance,while the control group was treated with traditional stereotactic hem atom a removal.The operation tim e,the clearance rate of hem atom a on the first day after operation,the incidence of rebleeding after operation and the incidence of complications were compared between the two groups.The prognosis of the two groups was compared after 6 months of follow-up.Results The operation time of the observation group was longer than that of the control group(P<0.01)»the clearance rate of hem atom a was higher in the observation group than that in the control group in the first day after operation(P<0.01),and the incidence of postoperative rebleeding was lower than that in the control group(P<0.05);the incidence of complications in the ob servation group wa.s lower than that in the control group(P<C0.05).A fter 6 months of follow-up,the GOS score of the observation group was significantly better than that of the control group(P<0.01).Conclusions Although Stereotactic guided neuroendoscopic hematoma removal through prefrontal keyhole approach for hypertensive patients with basal ganglia cerebral hem orrhage has a long operative time,it can sigmticantly.improve the 1hematoma removal rate,the incidence of postoperative rebleeding and complications.and the prognosis of patients.

关 键 词：高血压 基底节区 脑出血 立体定向 前额锁孔入路 神经内镜 血肿清除术 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]