中等量丘脑出血不伴急性脑积水的临床研究  

Clinical study on moderate thalamic hemorrhage without acute hydrocephalus

作　　者：曹玉魁 Cao Yukui(Department of Neurosurgery,Puyang Oilfield General Hospital,Puyang,Henan 457000,China)

机构地区：[1]濮阳油田总医院神经外科,河南濮阳457000

出　　处：《中国微侵袭神经外科杂志》2024年第7期420-423,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的为探讨经颞部无框架立体定向丘脑血肿穿刺引流术治疗不伴急性脑积水的中等量丘脑出血的临床疗效。方法回顾性分析81例中等量丘脑出血不伴急性脑积水患者的临床资料,其中行经颞部无框架立体定向丘脑血肿穿刺引流术31例(穿刺组),非手术治疗50例(保守组),对比两组临床效果。结果两组年龄、性别、高血压和糖尿病比例、抗凝药物服用、入院时格拉斯哥昏迷评分(Glasgow coma scale,GCS)、破入脑室发生率、丘脑出血量、肺部感染发生率、出血侧别以及治疗3个月内脑积水发生率,差异无统计学意义(均P>0.05)。穿刺组血肿排空时间及住院时间均短于保守组,差异具有统计学意义(P<0.05)。穿刺组在治疗3个月后改良Rankin量表(modified Rankin scale,mRS)评分低于保守组,差异具有统计学意义(P<0.05)。结论经颞部无框架立体定向丘脑血肿穿刺引流术治疗不伴急性脑积水的中等量丘脑出血,可短期内清除丘脑血肿,缩短血肿排空时间和住院时间,改善患者预后。Objective To investigate the clinical efficacy of temporal frameless stereotactic thalamic hematoma puncture and drainage in the treatment of moderate thalamic hemorrhage without acute hydrocephalus.Methods The clinical data of 81 patients with moderate thalamic hemorrhage without acute hydrocephalus were analyzed retrospectively.Among them,31 patients underwent temporal frameless stereotactic thalamic hematoma puncture and drainage(puncture group),while 50 patients received non-surgical treatment(conservative group).The clinical outcomes of the two groups were compared.Results There were no statistically significant differences between the two groups in terms of age,gender,proportions of hypertension and diabetes,use of anticoagulants,Glasgow coma scale(GCS)scores at admission,incidence of ventricular rupture,thalamic hematoma volume,incidence of pulmonary infection,laterality of hemorrhage,and incidence of hydrocephalus within 3 months of treatment(all P>0.05).The hematoma evacuation time and hospital stay were significantly shorter in the puncture group compared to the conservative group,with statistically significant differences(P<0.05).Furthermore,the modified Rankin scale(mRS)scores at 3 months after treatment were lower in the puncture group,indicating a statistically significant improvement in prognosis compared to the conservative group(P<0.05).Conclusions Temporal frameless stereotactic thalamic hematoma puncture and drainage for moderate thalamic hemorrhage without acute hydrocephalus can effectively evacuate the thalamic hematoma within a short period,reducing hematoma evacuation time and hospital stay,and improving patient prognosis.

关 键 词：脑出血 丘脑 立体定位技术 经颞部 临床疗效 

分 类 号：R743.34[医药卫生—神经病学与精神病学]