CAS-R-2无框架脑立体定向仪辅助钻孔引流术治疗高血压基底节区脑出血60例临床疗效分析  

Clinical effect analysis of CAS-R-2 frameless brain stereotactic apparatus assisted trepanation and drainage in the treatment of hypertensive basal ganglia cerebral hemorrhage

作　　者：刘东远[1] 王浩[1] 王森[1] 侯哲[1] 邰军利 张洪兵[1] Liu Dongyuan;Wang Hao;Wang Sen;Hou Zhe;Tai Junli;Zhang Hongbing(Department of Neurosurgery,Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京潞河医院神经外科,北京101149

出　　处：《中国医师进修杂志》2024年第7期631-635,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨CAS-R-2无框架脑立体定向仪辅助钻孔引流术在高血压基底节区脑出血治疗中的意义。方法回顾性分析2018年1月至2022年12月首都医科大学附属北京潞河医院60例行CAS-R-2无框架脑立体定向仪辅助钻孔引流术治疗的高血压基底节区脑出血患者的临床资料。记录手术相关指标和不良反应。术后6个月随访,采用格拉斯哥预后评分(GOS)评估预后。结果60例患者均顺利完成CAS-R-2无框架脑立体定向仪辅助钻孔引流术。手术时间(53±18)min;术后穿刺道血肿2例(3.3%),保守治疗后均吸收;术后脑内血肿均无扩大;术后保持引流管时间≤2 d 44例(73.3%),3~4 d 16例(26.7%),术后均未出现颅内感染;术后合并重症肺炎15例(25.0%),因重症肺炎合并多器官功能衰竭死亡2例(3.3%)。术后随访6个月,良好17例(28.3%),轻度残疾19例(31.7%),重度残疾16例(26.7%),植物生存状态6例(10.0%),死亡2例(3.3%)。结论CAS-R-2无框架脑立体定向仪辅助钻孔引流术治疗高血压基底节区脑出血具有操作简便、定位准确、创伤小及并发症少等特点,是治疗高血压基底节区脑出血的一种安全有效的方法。ObjectiveTo explore the significance of CAS-R-2 frameless brain stereotactic apparatus assisted trepanation and drainage in the treatment of hypertensive basal ganglia cerebral hemorrhage.MethodsThe clinical data of 60 patients with hypertensive basal ganglia cerebral hemorrhage,who underwent CAS-R-2 frameless brain stereotactic apparatus assisted trepanation and drainage in Beijing Luhe Hospital,Capital Medical University from January 2018 to December 2022,were retrospectively analyzed.The surgical related indexes and adverse reactions were recorded.The patients were followed up for 6 months,and the prognosis was evaluated using the Glasgow outcome score(GOS).ResultsA total of 60 cases of CAS-R-2 frameless brain stereotactic apparatus assisted trepanation and drainage were all successfully performed,and the operation time was(53±18)min.There were 2 cases(3.3%)of postoperative puncture path hematoma,which were completely resolved with conservative treatment.The expansion of postoperative intracerebral hematoma was not observed.The drainage tube retention after operation≤2 d was in 44 cases(73.3%),and the drainage tube retained for 3 to 4 d was in 16 cases(26.7%),all of them had no intracranial infection after operation.Fifteen cases(25.0%)were complicated with severe pneumonia after operation,and 2 cases(3.3%)died due to severe pneumonia combined with multiple organ failure.Follow up at 6 months after operation,17 cases(28.3%)were good,19 cases(31.7%)had mild disability,16 cases(26.7%)had severe disability,6 cases(10.0%)had vegetative survival status,and 2 cases(3.3%)died.ConclusionsThe CAS-R-2 frameless brain stereotactic instrument assisted trepanation and drainage for the treatment of hypertensive basal ganglia cerebral hemorrhage has the characteristics of simple operation,accurate positioning,minimal trauma,and fewer complications.It is a safe and effective method for treating hypertensive basal ganglia cerebral hemorrhage.

关 键 词：颅内出血 高血压性 脑血管基底神经节出血 引流术 无框架立体定向 

分 类 号：R651.12[医药卫生—外科学]