激光辅助下经额穿刺治疗基底节脑出血  

Treatment of basal ganglia hemorrhage with laser-assisted transfrontal puncture

作　　者：郭自强 薛长理 梁春东 闫妍 张海军 GUO Ziqiang;XUE ChangLi;LIANG Chundong;YAN Yan;ZHANG Haijun(Kaifen Central Hospital,Kaifeng,Henan 475000,China)

机构地区：[1]开封市中心医院,河南开封475000

出　　处：《中华神经外科疾病研究杂志》2024年第3期15-18,共4页Chinese Journal of Neurosurgical Disease Research

基　　金：开封市科技发展计划项目(1703044)。

摘　　要：目的探讨激光辅助下经额穿刺钻孔引流术治疗基底节区脑出血的临床应用。方法136例患者随机分为2组:研究组(激光辅助下经额穿刺治疗基底节脑出血)68例、对照组(常规经额穿刺治疗基底节脑出血)68例。比较两组肿清除率、手术时间、住院时间、住院费用、穿刺成功率、术后再出血发生率、颅内感染发生率;比较术前、术后1周、术后3个月的美国国立卫生研究院卒中量表(NIHSS)评分及格拉斯哥昏迷评分(GCS评分);比较术前、术后3个月的生活质量评分(SF-36)、日常生活能力评分(Barthel指数)。结果两组颅内感染发生率、术前GCS评分、NIHSS评分、生活质量评分、日常生活能力评分差异无统计学意义(P>0.05);研究组血肿清除率、手术时间、住院时间、住院费用、穿刺成功率、术后再出血发生率、术后1周及术后3个月GCS评分和NIHSS评分、术后3个月生活质量评分和日常生活能力评分均优于对照组(P<0.01)。结论经激光辅助下经额穿刺钻孔引流术治疗基底节区出血与常规经穿刺治疗相比,穿刺成功率高、手术时间短、再出血发生率低、住院时间短、住院费用低、预后好,适合推广。Objective To study the clinical application of laser-assisted trepanation and drainage through frontal puncture in the treatment of cerebral hemorrhage in basal ganglia.Methods 136 patients were randomly divided into a study group(laser-assisted transfrontal puncture for basal ganglia hemorrhage)(68 cases)and a control group(conventional transfrontal puncture for basal ganglia hemorrhage)(68 cases).A three stage comparison of related data was made between these two groups,first,the clearance rate of hematoma,surgical time,length of hospital stay,hospitalization costs,success rate of puncture procedure,postoperative rebleeding rate,intracranial infection rate of the tow groups,second,Glasgow Coma Scale(GCS)scores and National Institutes of Health Stroke Scale(NIHSS)scores before surgery,1 week after surgery,and 3 months after surgery,and finally quality of life scores(SF-36 Quality of Life Questionnaire)and daily living ability scores(using Barthel Index)before surgery and 3 months after surgery.Results There were no statistically significant differences in the incidence of intracranial infection,preoperative GCS scores,NIHSS score,quality of life scores,and daily living ability scores between the two groups(P>0.05).However,the study group had better outcomes compared to the control group in terms of hematoma clearance rate,operation time,length of hospital stay,hospitalization costs,puncture success rate,postoperative rebleeding rate,GCS scores and NIHSS scores at 1 week and 3 months after surgery as well as quality of life scores and daily living ability scores at 3 months after surgery(P<0.01).Conclusion Laser-assisted transfrontal puncture and drainage can be widely used on the treatment of basal ganglia hemorrhage as it has higher success rate in puncture,shorter operation time,lower rebleeding rate,shorter hospital stay,lower hospital costs,and better prognosis compared to conventional puncture treatment.

关 键 词：基底节出血 经额穿刺 激光辅助下定位 

分 类 号：R651.1[医药卫生—外科学]