立体定向抽吸联合肾上腺素灌洗治疗基底节区高血压性脑出血的疗效  

The effect of stereotactic aspiration combined with adrenaline lavage in the treatment of hypertensive intracerebral hemorrhage at the basal ganglia

作　　者：阮升 吴淳 侯勇[1] 俞国松 周锦萍 泮双军[1] Ruan Sheng

机构地区：[1]浙江省台州医院,317000

出　　处：《浙江临床医学》2021年第10期1416-1418,1421,共4页Zhejiang Clinical Medical Journal

基　　金：浙江省台州市科技计划项目(1901ky08)。

摘　　要：目的探讨基于Leksell头架的CT引导下立体定向抽吸联合肾上腺素灌洗治疗基底节区高血压性脑出血(HICH)的疗效。方法150例基底节区HICH患者随机分为A、B、C三组,每组各50例。A组接受基于Leksell头架的CT引导下立体定向抽吸联合肾上腺素灌洗,B组仅接受基于Leksell头架的CT引导下立体定向抽吸,C组接受传统开颅手术。比较三组的手术时间、住院时间、术后血肿残余量、术后并发症情况,以及治疗前后的GCS评分、NIHSS评分、BI指数。结果A、B组的手术时间短于C组,A、B两组无统计学差异(P>0.05)。A组的住院时间短于B、C组,B组短于C组(P<0.05)。A组的并发症发生率低于B、C组,B组低于C组(P<0.05)。A、C组的术后残余血肿量少于B组(P<0.05),A、C两组无统计学差异(P>0.05)=术后三组的GCS评分、NIHSS评分、BI指数较术前均明显改善(P<0.05)。A、B组术后的GCS评分、NIHSS评分、BI指数均优于C组(P<0.05),A组的术后GCS评分与B组比较无统计学差异(P>0.05),A组术后的NIHSS评分、BI指数优于13组(P<0.05)。结论立体定向抽吸联合肾上腺素灌洗治疗基底节区HICH具有良好的血肿清除效果,可缩短手术及住院时间,降低并发症的发生率,有助于神经功能和活动能力的恢复。Objective To investigate the effect of stereotactic aspiration combined with adrenaline lavage in the treatment of hypertensive intracterebral hemorrhage(HICH)in basal ganglia under CT guidance based on Leksell's head rest.Methods 150 patients with HICH in basal ganglia were randomly divided into three groups(group A,group B and group C),50 patients in each group.Group A received CT-guided stereotactic aspiration combined with epinephrine irrigation based on Leksell head frame,group B only received CT-guided stereotactic aspiration based on Leksell head frame,and group C received traditional craniotomy.The operation time,length of stay,residual amount of postoperative hematoma,postoperative complications,GCS score,NIHSS score and BI index before and after treatment were compared among the three groups.Results The operation time of group A and B was shorter than that of group C,and there was no statistical difference between groups A and B(P>0.05).The length of hospital stay in group A was shorter than that in group B and C,and group B was shorter than that in group C(P<0.05).The complication rate of group A was lower than that of group B and C,that of group B was lower than that of group C(P<0.05).The amount of postoperative residual hematoma in group A and C was less than that in group B(P<0.05),and there was no statistical difference between group A and C(P>0.05).The GCS score,NIHSS score and BI index of the three groups were significandy improved after surgery(P<0.05).Postoperative GCS score,NIHSS score and BI index of group A and B were better than those of group C(P<0.05),postoperative GCS score of group A was not statistically different from that of group B(P>0.05),postoperative NIHSS score and BI index of group A were better than that of group 13(P<0.05).Conclusion Stereotactic aspiration combined with epinephrine lavage in the treatment of basal ganglia HICH has a good effect on the removal of hematoma,and it can shorten the length of surgery and hospital stay,reduce the incidence of complications,and con

关 键 词：高血压性脑出血 基底节区 立体定向穿刺 肾上腺素 

分 类 号：R65[医药卫生—外科学]