基底节脑出血治疗中软通道微创方法的不同部位穿刺应用效果观察  

Application Effect Observation of Soft Channel Minimally Invasive Puncture for Basal Ganglia Intracerebral Hemorrhage At Different Parts

作　　者：张朔 ZHANG Shuo(Neurosurgery Department,Zibo City Zichuan District Hospital,Zibo,Shandong 255100)

机构地区：[1]山东省淄博市淄川区医院神经外科,山东淄博255100

出　　处：《智慧健康》2023年第21期153-156,161,共5页Smart Healthcare

摘　　要：目的 观察基底节脑出血治疗中软通道微创方法的经额和经颞不同部位穿刺应用效果,以期从中遴选一种更加安全高效的手术方案。方法 回顾性分析2019年3月-2022年3月在本院接受神经内镜下微创治疗的90例基底节脑出血患者的临床资料,根据手术入路方式的不同将患者分为经额穿刺入路组(经额穿刺组)和经颞穿刺入路组(经颞穿刺组),每组各45例,观察两组患者近远期手术治疗效果及并发症发生率。结果 统计两组患者手术操作耗时,组间无差异(P>0.05);术后24h复查患者颅脑CT,计算两组患者血肿清除率并进行比较,经额穿刺组患者显著高于经颞穿刺组;统计两组患者引流管留置时间及住院治疗天数,经额穿刺组统计结果明显短于经颞穿刺组(P<0.05);经颞穿刺组患者脑梗死及脑血管痉挛发生率显著高于经额穿刺组(P<0.05);术后6个月,经额穿刺组患者NIHSS评分及mRS分级明显低于经颞穿刺组患者,BI指数显著高于经颞穿刺组患者(P<0.05)。结论 软通道微创技术治疗基底节脑出血时,经额穿刺入路相对于经颞穿刺入路可以显著提高血肿清除率,降低术后脑梗死及脑血管痉挛发生率,加快患者的康复进程,改善预后。Objective To observe effect of minimally invasive soft channel puncture in treatment of basal ganglia intracerebral hemorrhage in different parts of frontal and temporal area,to choose a safer and more efficient surgical plan.Methods The paper reviewed and analyzed clinical data of 90 patients with basal ganglia intracerebral hemorrhage with minimally invasive neuroendoscopy in our hospital from March 2019 to March 2022,and divided them into frontal puncture approach group(frontal puncture group)and temporal puncture approach group(temporal puncture group)according to different surgical approaches,with 45 cases in each group.Short-term and long-term surgical treatment effect and incidence of complications was observed between two groups.Results There was no difference in surgical procedure time between two groups(P>0.05).After 24 hours of surgery,brain CT reexamination showed,hematoma clearance rate was calculated and compared between two groups,that of frontal puncture group was significantly higher than temporal puncture group.Retention time of drainage tube and length of stay between two groups was statistically analyzed,that of frontal puncture group was significantly shorter than temporal puncture group(P<0.05).Incidence of cerebral infarction and cerebral vasospasm in temporal puncture group was significantly higher than frontal puncture group(P<0.05).6 months after surgery,NIHSS scores and mRS grading of frontal puncture group were significantly lower than temporal puncture group,and BI index was significantly higher than temporal puncture group(P<0.05).Conclusion Soft channel minimally invasive technology can improve hematoma clearance rate more significantly for basal ganglia cerebral hemorrhage through frontal puncture approach than temporal puncture approach,which can reduce incidence of postoperative cerebral infarction and cerebral vasospasm,accelerate recovery process and improve prognosis of patients.

关 键 词：基底节脑出血 软通道微创方法 不同部位穿刺 应用效果 

分 类 号：R651.1[医药卫生—外科学]