摘要
目的探讨CT引导下立体定向微创引流术治疗高血压小脑出血的临床疗效。方法自2013年1月至2016年6月,解放军第二五一医院神经外科对23例高血压小脑出血患者进行了立体定向微创引流治疗,与同期按家属意愿行后颅窝开颅血肿清除术治疗的23例高血压小脑出血患者进行比较(出血量均为10~20 ml)。立体定向组在CT引导下行立体定向微创引流术,术后血肿腔内注入尿激酶溶解清除血肿;开颅手术组在全麻下行后颅窝开颅,显微镜下清除血肿,术后给予止血、脱水等治疗。结果立体定向组的住院时间明显短于开颅手术组的住院时间,差异具有统计学意义(P=0.01);立体定向组的术后并发症低于开颅手术组的术后并发症,差异具有统计学意义(P=0.03);立体定向组的血肿排空时间较开颅手术组的血肿排空时间长,差异具有统计学意义(P=0.04);治疗6个月后的日常生活能力评定分级立体定向组与开颅手术组间差异无统计学意义(P=0.33)。结论应用立体定向微创引流术治疗高血压小脑出血可获得与后颅窝开颅术相当的清除效果,且定位准确、创伤小、并发症少、治疗时间短,值得临床推广应用。
Objective To investigate the therapeutic effect of CT-guided stereotactic minimal invasive and drainage for hypertensive eerebellar hemorrhage. Methods Twenty-three cases of hypertensive cerebellar hemorrhage patients treated with stereotactic minimally invasive drainage were retrospectively analyzed in our hospital from January 2013 to June 2016, compared the efficacy with the other 23 patients who underwent posterior fossa craniotomy with hematoma removal at the same time period. The amount of bleeding of two groups were both 10-20 ml. The stereotatic group was given CT- guided stereotactic minimal invasive and drainage treatment, after operation, poured urokinase into the hematoma to dissolved it. The eraniotomy group was performed posterior cranial fossa craniotomy after general anesthesia and the hemotoma was removaled by the mierosurgery, after operation, the hemostasis, dehydration etc were given to the patients. Results The average hospitalization days of the stereotatic group was significantly shorter than the craniotomy group （P=0.01）. The postoperative complication of the stereotatic group less than the craniotomy group （P=0.03）. The emptying time of hematoma of the stereotatic group langer than the craniotomy group （P=0.04）. The activities of daily living classification after six months treatment of the stereotatic group no statistical difference with the craniotomy group （P= 0.33）. Conclusion The stereotactic minimal invasive and drainage for cerebellar hemorrhage could achieve considerabl reset effect compare with the posterior cranial fossa craniotomy, and it was accurate positioning, little injury, less complication, shorter hospitalization and so on. The stereotactic minimal invasive and drainage for hypertensive cerebellar hemorrhage is worthy for the clinical popularization and application.
出处
《中华神经创伤外科电子杂志》
2017年第3期146-150,共5页
Chinese Journal Of Neurotraumatic Surgery：Electronic Edition
关键词
脑出血
小脑
高血压
立体定向
Cerebral hemorrhage
Cerebal
Hypertension
Stereotaxis
