立体定向穿刺引流术治疗基底节区脑出血的价值探究  

Value of stereotactic puncture drainage in the treatment of basal ganglia cerebral hemorrhage

作　　者：林振飞 陈世洁[1] Lin Zhenfei;Chen Shijie(Department of Craniocerebral Surgery,Jingzhou First People's Hospital Affiliated to Yangtze University,Jingzhou 434021,China)

机构地区：[1]长江大学附属荆州市第一人民医院颅脑外科,湖北荆州434021

出　　处：《中华神经创伤外科电子杂志》2022年第1期34-38,共5页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

摘　　要：目的探究立体定向穿刺引流术治疗基底节区脑出血的临床应用价值。方法回顾性分析长江大学附属荆州市第一人民医院颅脑外科自2019年6月至2020年6月治疗的66例基底节区脑出血患者的临床资料,根据手术方式的不同分为2组,其中行传统开颅手术治疗的33例患者为对照组,采用立体定向穿刺引流术治疗的33例患者为引流组,观察并比较2组患者围术期指标、疗效、血清水通道蛋白4(AQP4)、血小板反应蛋白(TSP)1和TSP2水平、脑水肿体积。结果引流组手术时间及住院时间均短于对照组,术中失血量低于对照组,血肿清除率高于对照组,差异有统计学意义(P<0.05);引流组术后疗效较对照组好,差异有统计学意义(P<0.05);引流组患者血清AQP4、TSP1、TSP2水平较对照组低,脑水肿体积较对照组小,差异有统计学意义(P<0.05)。结论立体定向穿刺引流术治疗可改善基底节区脑出血患者围术期指标、增强疗效、降低血清AQP4水平、减少脑水肿体积。Objective To explore the clinical application value of stereotactic puncture drainage in the treatment of basal ganglia cerebral hemorrhage.Methods Retrospective analysis was performed on the clinical data of 66 patients with basal ganglia cerebral hemorrhage treated in Craniocerebral Surgery Department of Jingzhou First People's Hospital Affiliated to Yangtze University between June 2019 and June 2020.According to different surgical methods,33 patients undergoing traditional craniotomy were selected as control group,and another 33 patients treated with stereotactic puncture drainage during the same period were enrolled as drainage group.Perioperative indicators,efficacy,serum aquaporin 4(AQP4),thrombospondin(TSP)1 and TSP2 and cerebral edema volume were observed and compared between the two groups.Results The surgical time and hospital stay of drainage group were shorter than those of control group,and the intraoperative blood loss was lower than that of control group while the hematoma clearance rate was higher than that of control group(P<0.05).The postoperative efficacy was better in drainage group than that in control group(P<0.05).The levels of serum AQP4,TSP1 and TSP2 of patients in drainage group were lower than those of control group,the volume of cerebral edema in drainage group was lower than that in the control group(P<0.05).Conclusion Stereotactic puncture drainage can improve the perioperative indicators,enhance the efficacy,lower the level of serum AQP4 and reduce the volume of cerebral edema of patients with basal ganglia cerebral hemorrhage.

关 键 词：立体定向穿刺引流术 基底节区脑出血 围术期指标 疗效 脑水肿 血清水通道蛋白第4亚型 

分 类 号：R651.1[医药卫生—外科学]