应用DTI评估钻孔引流和小骨窗两种术式治疗中等量基底节区脑出血的预后情况

发布时间：2018-11-12 10:52

【摘要】：目的通过弥散张量成像技术(diffusion tensor imaging,DTI)评估钻孔引流和小骨窗两种术式治疗中等量基底节区脑出血的临床效果。方法回顾性分析我科自2013年6月~2015年9月,共收治中等量(30~60 ml)基底节区脑出血58例,其中28例采用钻孔引流手术(A组),30例采用小骨窗显微手术组(B组),所有患者均在术前及术后2周进行DTI扫描,获取双侧皮质脊髓束(corticospinal tract,CST)的各项异性分数(fractional anisotropy,FA),分别观察对比两者术后第1天血肿清除率、手术时间、术中出血量、再出血、颅内感染、术后2周患侧FA值、术后3个月GOS评分。结果在血肿清除率方面,B组优于A组(P0.05),在再出血及颅内感染方面,二者并无明显区别(P0.05),而在手术时间,术中出血量,术后2周患侧FA值,术后3个月GOS评分,A组均优于B组(P0.05)。结论 DTI是可以早期评估基底节区脑出血预后的一项有效技术,钻孔引流治疗中等量基底节区出血血肿创伤更小,手术时间短,术后恢复快,疗效确切。
[Abstract]:Objective to evaluate the clinical effect of drilling drainage and small bone window in the treatment of moderate basal ganglia intracerebral hemorrhage by diffusion Zhang Liang imaging technique (diffusion tensor imaging,DTI). Methods from June 2013 to September 2015, 58 patients with moderate basal ganglia hemorrhage (30 ~ 60 ml) were treated. Among them, 28 cases were treated by drilling drainage (group A) and 30 cases by small bone window microsurgery (group B). All the patients underwent DTI scanning before and 2 weeks after operation to obtain the heterosexual scores (fractional anisotropy,FA) of bilateral corticospinal tract (corticospinal tract,CST). The hematoma clearance rate and operative time were observed and compared on the first day after operation. Intraoperative bleeding, rebleeding, intracranial infection, 2 weeks after the affected side FA, 3 months after the GOS score. Results the hematoma clearance rate in group B was better than that in group A (P0.05), but there was no significant difference between the two groups in terms of rebleeding and intracranial infection (P0.05). However, the time of operation, the amount of intraoperative bleeding and the FA value of the affected side 2 weeks after operation were not significantly different between the two groups. The GOS score of group A was better than that of group B 3 months after operation (P0.05). Conclusion DTI is an effective technique for early evaluation of prognosis of intracerebral hemorrhage in basal ganglia area.
【作者单位】：解放军第180医院神经外科;
【基金】：南京军区医药卫生科研项目(编号:14MS092)
【分类号】：R651.1

【相似文献】