基于体表标志定位急诊单引流管双靶点治疗丘脑出血破入脑室伴脑积水  

Emergency single drainage tube and dual target thalamic hematoma ventricular drainage surgery based on body surface marker localization for the treatment of thalamic hemorrhage breaking into the ventricle with hydrocephalus

作　　者：贾宝铭 赵建凯 汪丽珍 周西广 裴红莎 张颜礼 冯国强 库洪彬 JIA Baoming;ZHAO Jiankai;WANG Lizhen;ZHOU Xiguang;PEI Hongsha;ZHANG Yanli;FENG Guo-qiang;KU Hongbin(Department of Neurosurgery,the Third Hospital of Xingtai City,Xingtai 054000,China)

机构地区：[1]河北省邢台市第三医院神经外科,邢台054000

出　　处：《中国神经精神疾病杂志》2024年第1期23-29,共7页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的 探讨颞部体表定位急诊单引流管双靶点丘脑血肿脑室引流术在丘脑出血破入脑室伴脑积水治疗中的应用价值。方法 回顾性选择丘脑出血破入脑室伴脑积水患者223例,其中包括采取颞部体表定位急诊单引流管双靶点丘脑血肿脑室引流术的研究组115例,以及先行急诊脑室外引流,病情稳定后再行立体定向丘脑血肿引流术的对照组108例。对比2组患者术后并发症及治疗效果的差异,评价颞部体表定位单引流管双靶点丘脑血肿脑室引流术在丘脑出血破入脑室伴脑积水治疗中的应用价值。结果研究组与对照组丘脑术后再出血率(5.2%vs.4.7%)、血肿清除率(87.5%±7.3%vs.90.2%±8.5%)、死亡率(13.9%vs.15.7%)比较差异无统计学意义(P>0.05)。研究组与对照组带管时间、术后颅内感染、分流依赖型脑积水、治疗有效、预后良好分别为(75.5±18.4)h、3.5%、19.1%、53.9%、51.3%与(130.8±22.9)h、13.9%、35.1%、38.7%、38.0%,2组比较差异有统计学意义(P<0.05)。结论 急诊颞部体表定位单引流管双靶点丘脑血肿脑室引流术治疗丘脑出血破入脑室伴脑积水,手术安全可靠,可改善患者预后。Objective To explore the application value of emergency temporal body surface positioning for single drain dual-target thalamic hematoma ventricular drainage in the treatment of thalamic hemorrhage breaking into ventricle with hydrocephalus.Methods A retrospective analysis was conducted on 223 patients with thalamic hemorrhage breaking into the ventricles with hydrocephalus,including a study group of 115 cases who underwent emergency single drain dual-target thalamic hematoma ventricular drainage surgery with temporal body surface positioning,and a control group of 108 cases who underwent emergency ventricular drainage first and then underwent stereotactic thalamic hematoma drainage surgery after the condition stabilized.Compare the differences in postoperative complications and treatment outcomes between two groups of patients,and evaluate the application value of temporal surface positioning for single drain dual-target thalamic hematoma ventricular drainage surgery in the treatment of thalamic hemorrhage breaking into the ventricle with hydrocephalus.Results The postoperative rebleeding rates,hematoma clearance and death were 5.2%,87.5%±7.3%and 13.9%in the study group and 4.7%,90.2%±8.5%and 15.7%in control group,respectively.There was no significant difference between the two groups(P>0.05).The tube time,postoperative intracranial infection,Shunt dependent hydrocephalus,effective treatment and favorable prognosis of and the control group were(75.5±18.4)h,3.5%,19.1%,53.9%and 51.3%in the study group and(130.8±22.9)h,13.9%,35.1%,38.7%and 38.0%,respectively.The difference between the two groups was statistically significant(P<0.05).Conclusion Body surface landmark-guided emergency single drain dual-target thalamic hematoma ventricular drainage surgery for the treatment of thalamic hemorrhage breaking into the ventricle with hydrocephalus is safe and reliable,and can improve the patient's prognosis.

关 键 词：丘脑出血破入脑室 脑积水 引流术 体表标志 定位 单引流管双靶点 

分 类 号：R743.34[医药卫生—神经病学与精神病学]