摘要
目的探讨神经导航下钻孔引流术对高血压性脑出血患者皮质脊髓束形态功能及神经功能损伤程度的影响。方法选择2015年1月~2016年1月于湖北省襄阳市中心医院就诊的高血压性脑出血患者56例,按随机数字表法分为两组,对照组28例患者,行保守治疗,观察组28例患者,行神经导航下钻孔引流术,分别于发病前、发病后3个月进行患侧/对侧的各向异性(FA)值比率检查,比较皮质脊髓束损伤分级(CST)1~3级和CST4级差异,同时采取美国国立卫生研究院中(NIHSS)对患者神经功能改善情况进行评定。结果两组患者性别、年龄、出血部位及CST受损情况等基线资料比较差异无统计学意义(P>0.05)。两组患者发病前FA值差异无统计学意义(P>0.05);两组患者发病后3个月FA值显著高于发病前(P<0.05);观察组CST1~3级患者FA值高于对照组(P<0.05);两组CST 4级患者发病后3个月FA值组间差异无统计学意义(P>0.05);两组患者发病前NIHSS评分比较差异无统计学意义(P>0.05);两组患者发病后3个月NIHSS评分显著低于发病前(P<0.05);观察组发病后3个月NIHSS评分显著低于对照组(P<0.05)。结论神经导航下钻孔引流术治疗高血压性脑出血的临床疗效较保守治疗更有优势。
Objective To investigate the influence of borehole drainage guided by neuronavigation system on morphological function of corticospinal tract （CST） and severity of neurological impairment in patients with hypertensive intracerebral hemorrhage （HIH）. Methods HIH patients （n=56） were chosen from the Central Hospital of Xiangyang City of Hubei Province from Jan. 2015 to Jan. 2016, and then randomly divided into control group treated with conservative therapy and observation group treated with borehole drainage guided by neuronavigation system （each n=28）. The ratio of values of ipsilateral/contralateral fractional anisotropy （FA） was examined before and after HIH onset for 3 months. The difference between grades 1-3 CST impairment and grade 4 CST impairment was compared, and improvement of neurological function was reviewed based on National Institute of Health Stroke Scale （NIHSS）. Results The difference in baseline material including sex, age, bleeding position and CST impairment had no statistical significance between 2 groups （P〉0.05）. The difference in FA value had no significance between 2 groups before HIH onset （P〉0.05）. FA value was significantly higher in 2 groups after HIH onset for 3 months than before （P〈0.05）. FA value was higher in patients with grades 1-3 CST impairment in observation group than that in control group （P〈0.05）. The difference in FA value had no statistical significance in patients with grade 4 CST impairment between 2 groups after HIH onset for 3 months （P〉0.05）. The difference in NIHSS score had no statistical significance between 2 groups before HIH onset （P〉0.05）. NIHSS score was significantly lower in 2 groups after HIH onset for 3 months than before （P〈0.05）. NIHSS score was significantly lower in observation group than that in control group after HIH onset for 3 months （P〈0.05）. Conclusion The curative effect of borehole drainage guided by neuronavigation system has more advantages than conse
出处
《中国循证心血管医学杂志》
2017年第12期1501-1503,1506,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
高血压性脑出血
皮质脊髓束
预后
Hypertensive intracerebral hemorrhage
Corticospinal tract
Prognosis
