河北医科大学学报

• 论著 • 上一篇    下一篇

微创经额穿刺治疗基底节出血的临床研究#br#

  

  1. 1.河北医科大学第二医院神经外科，河北 石家庄 050000；2.吉林大学第二医院神经外科,吉林 长春 130041
  • 出版日期:2017-08-25 发布日期:2017-08-09
  • 作者简介:郑军（1979-）男，河北霸州人，河北医科大学第二医院主治医师，医学硕士，主要从事脑血管疾病诊治研究。
  • 基金资助:
    河北省医学科学研究重点课题（20160575）

Clinical research on minimally invasive transfrontal craniopuncture for spontaneous basal ganglia hemorrhage#br#

  1. 1.Department of Neurosurgery， the Second Hospital of Hebei Medical University， Shijiazhuang
    050000， China； 2.Department of Neurosurgery， the Second Hospital of Jilin
    University， Changchun 130041， China
  • Online:2017-08-25 Published:2017-08-09

HTML

PDF (PC)

170

摘要： ［摘要］〓
〖HTH〗目的〖HTSS〗〖KG*2〗探讨微创经额穿刺治疗基底节出血的技术方法和临床疗效。
〖HTH〗方法〖HTSS〗〖KG*2〗阐述微创经额穿刺的解剖特点及技术要点，对65例高血压脑出血患者经CT定位后行微创微额穿刺，抽吸血肿，结合经引流管血肿腔注射尿激酶促进血肿引流，记录血肿清除率，常见并发症，卒中评分即格拉斯哥昏迷量表（Glasgow Coma Scale,GCS）评分、美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale,NIHSS）评分、Barthel指数（Barthel index,BI），评价近期及远期疗效。
〖HTH〗结果〖HTSS〗〖KG*2〗术后1周和术后3个月GCS评分明显高于术前，术后3个月又高于术后1周，术后1周和术后3个月NIHSS评分低于术前，术后3个月又低于术后1周，差异均有统计学意义(P＜005)；血肿清除率88.1%；BI评分1级24例（36.9%），2级23例（35.4%），3级9例（13.8%），4级5例（7.7%），5级3例（4.6%）。术后再出血3例（4.6%），颅内感染2例（3.1%），死亡1例（1.5%）。
〖HTH〗结论〖HTSS〗〖KG*2〗微创经额穿刺可以有效清除中量和小量基底节血肿，促进患者神经功能恢复，明显提高患者的日常生活能力，其操作简单，安全有效。

关键词: 脑出血, 微创锥颅术, 尿激酶型纤溶酶原激活物

Abstract: ［Abstract］ Objective〖HTSS〗〓To evaluate the technique and curative effect of minimally invasive transfrontal craniopuncture for spontaneous basal ganglia hemorrhage.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The microanatomy and technique of minimally invasive transfrontal craniopuncture were elaborated. Sixtyfive patients with basal ganglia hemorrhage were urderwent CTguided  minimally invasive transfrontal craniopuncture. The hematoma was aspirated and the urinary plasminogen activator was injected into the hematoma through a soft catheter to promote the evacuation of hematoma. The evacuation rate of hematoma, the common complications, and the stroke scales were recorded, containing Glasgow Coma Scale(GCS), National Institutes of Health Stroke Scale(NIHSS), and Barthel Index(BI). The shortterm and longterm efficacy was evaluated.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The GCS score at 1 week and 3 months after operation was significantly higher than that before the operation, and the postoperative GCS scores at 3 months were significantly higher than of 1 week. 1 week and 3 months after operation, the NIHSS score was lower than that before operation, and the 3 months after operation were lower than 1 week after operation, the difference was statistically significant(P＜0.05). The evacuation rate of hematoma was 88.1%. There were 24 patients（36.9%） in grade one of BI score, 23 patients（35.4%） in grade two, 9 patients（13.8%） in grade three， 5 patients（7.7%） in grade four，3 patients（4.6%） in grade five. There were 3 patients（4.6%） with rebleeding, 2 patients（3.1%） with intracranial infection, and 1（1.5%） death.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The minimally invasive transfrontal craniopuncture technique could remove the hematoma of small and medium volume basal ganglia effectively, improve neurological outcome, and significantly improve the activities of daily living. It is easy to operate, and is a safe and practical technique in treating cerebral hemorrhage.

Key words: cerebral hemorrhage； , minimally invasive craniopuncture； urokinasetype plasminogen activator

版权所有 © 《河北医科大学学报》编辑部
本系统由北京玛格泰克科技发展有限公司设计开发