CT定向下双靶点微创穿刺引流术治疗丘脑出血破入脑室的临床研究  

Effects of CT-guided dual-target minimally invasive puncture on nerve injury degree and cerebral hemodynamics in patients with thalamic hemorrhage breaking into ventricles

作　　者：李炯[1] 吴过[1] 郭文才[1] 李锐[1] 李龙祥 LI Jiong;WU Guo;GUO Wencai;LI Rui;LI Longxiang(Bazhong Central Hospital,Bazhong,636600 China)

机构地区：[1]巴中市中心医院,四川巴中636600

出　　处：《中国实用神经疾病杂志》2023年第3期323-327,共5页Chinese Journal of Practical Nervous Diseases

基　　金：四川省卫生计生委科研课题(编号:17PJ407)。

摘　　要：目的探究CT定向下侧脑室联合丘脑血肿双靶点微创穿刺引流术治疗丘脑出血破入脑室对患者神经损伤程度及脑部血流动力学的影响。方法采用随机数字表法将2017-06—2021-02巴中市中心医院收治的98例丘脑出血破入脑室患者分为2组。对照组49例,给予侧脑室穿刺引流术治疗。观察组49例,给予CT定向下侧脑室联合丘脑血肿双靶点微创穿刺引流术治疗。比较2组血肿清除率、再出血率、颅内感染率、手术相关指标及格拉斯哥预后评分(GOS);观察患者手术前后脑部血流动力学指标,并统计术后并发症发生情况。结果观察组血肿清除率高于对照组[(92.15±3.68)%vs(86.87±4.59)%,P<0.05],术后收缩期峰值流速(PSV)、舒张末期血流速度(EDV)高于对照组[(85.02±6.93)cm/s、(37.12±3.85)cm/s vs(79.38±6.24)cm/s、(34.95±4.07)cm/s,P<0.05],GOS评分优于对照组(P<0.05);2组颅内感染率、术后并发症发生率对比差异无统计学意义(P>0.05)。结论CT定向下侧脑室联合丘脑血肿双靶点微创穿刺引流术治疗丘脑出血破入脑室的血肿清除率高,能缩短术后恢复时间,并可改善患者脑部血流动力学。Objective To explore the effect of CT-guided dual-target minimally invasive puncture on nerve injury degree and cerebral hemodynamics in patients with thalamic hemorrhage breaking into ventricles.Methods A total of 98 patients with thalamic hemorrhage breaking into ventricles were enrolled as the research objects between June 2017 and February 2021.According to random number table method,they were divided into two groups,49 cases/group.The control group was given lateral ventricle puncture,while observation group was given CT-guided dual-target minimally invasive puncture of lateral ventricle combined with thalamus hematoma.The hematoma clearance rate,rebleeding rate,incidence of intracranial infection,surgery-related indexes and score of Glasgow Outcome Scale(GOS)were compared between the two groups.The cerebral hemodynamics indexes were observed before and after surgery.The occurrence of postoperative complications was statistically analyzed.Results The hematoma clearance rate in observation group was higher than that in control group[(92.15±3.68)%vs(86.87±4.59)%,P<0.05].After surgery,peak systolic velocity(PSV)and end-diastolic velocity(EDV)in observation group were higher than those in control group[(85.02±6.93)cm/s,(37.12±3.85)cm/s vs(79.38±6.24)cm/s,(34.95±4.07)cm/s,P<0.05],and GOS score was better than that in control group(P<0.05).There was no significant difference in incidence of intracranial infection and postoperative complication between the two groups(P>0.05).Conclusion The hematoma clearance rate of CT-guided dual-target minimally invasive punc⁃ture of lateral ventricle combined with thalamus hematoma is high in the treatment of thalamic hemorrhage breaking into ventricles,which can shorten postoperative recovery time,and improve cerebral hemodynamics in patients.

关 键 词：CT定向 侧脑室穿刺引流术 丘脑血肿穿刺引流术 丘脑出血破入脑室 血肿清除率 脑部血流动力学 

分 类 号：R743.34[医药卫生—神经病学与精神病学]