立体定向与简易定位颅内置管治疗中等量高血压脑出血患者临床效果比较

发布时间：2018-05-11 08:18

本文选题：高血压脑出血 + 立体定向　；参考：《吉林大学学报(医学版)》2017年01期

【摘要】：目的:探讨立体定向仪引导颅骨钻孔置管吸引术和应用简易marker定位法引导颅骨钻孔置管吸引术治疗中等量高血压脑出血(HICH)2种术式的优缺点,为临床医师选择治疗中等量HICH的合理术式提供参考。方法:选取因HICH急诊入本院行颅骨钻孔置管吸引术患者43例,依照患者家属意愿,采用立体定向颅骨钻孔置管吸引术治疗20例(立体定向组),应用简易marker定位法引导颅骨钻孔置管吸引术治疗23例(简易定位组),均为中等出血量(30~70mL)的基底节区HICH患者。观察并记录患者术后第1和3天血肿清除率、术后引流管留置时间、引流管在血肿腔内的长度、术后置管精确度、术后并发症和术后6个月格拉斯哥预后评分(GOS评分)。结果:与简易定位组比较,立体定向组患者术后置管精确度、术后第1天血肿清除率和术后6个月GOS评分明显升高(P0.05),术后第3天血肿清除率、术后引流管留置时间、并发症发生率和再出血率比较差异均无统计学意义(P0.05)。结论:对于中等量HICH患者,立体定向引导颅骨钻孔置管吸引术临床效果确切。及早清除颅内血肿可能更有利于改善患者HICH远期预后,值得临床上推广应用。
[Abstract]:Objective: To explore the advantages and disadvantages of the stereotactic guided cranial drilling intubation and the application of simple marker positioning method to guide the treatment of 2 kinds of hypertensive intracerebral hemorrhage (HICH) in the treatment of the same amount of hypertensive intracerebral hemorrhage (HICH), and provide a reference for the clinicians to choose the reasonable operation of the equal amount of HICH in the treatment. In 43 cases, 20 cases (stereotactic group) were treated by stereotactic cranial drilling and intubation in accordance with the wishes of the patients' families. 23 cases of HICH in the basal ganglia area with moderate bleeding (30~70mL) were treated with simple marker positioning method. First and third days postoperative hematoma clearance rate, postoperative drainage tube retention time, drainage tube length in hematoma, postoperative catheter accuracy, postoperative complications and 6 months after the operation of Glasgow prognosis score (GOS score). Results: compared with the simple positioning group, stereotactic group patients post operation accuracy, hematoma clearance rate and postoperative 6 after first days after operation 6. The GOS score of the month was significantly higher (P0.05). There was no significant difference in hematoma clearance rate, drainage tube retention time, complication rate and rebleeding rate after third days of operation (P0.05). Conclusion: for patients with moderate HICH, stereotactic guidance of cranial drilling intubation is effective. It may be more effective to remove intracranial hematoma as soon as possible. It is beneficial to improve the long-term prognosis of HICH, and is worthy of clinical application.

【作者单位】：吉林大学中日联谊医院神经外科;
【基金】：吉林省科技厅科技发展计划项目资助课题(20150201088SF)
【分类号】：R651.12

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