摘要
目的探讨立体定向微创不同穿刺针数清除颅内血肿及降低颅内压的效果。方法选择72例幕上脑出血量为30-55 mL行立体定向微创穿刺颅内血肿清除患者,根据不同手术穿刺针数分为两针穿刺组(36例)和单针穿刺组(36例)。两组均将未带有引流管的颅内压传感器置入血肿边缘监测颅内压。分别对两组患者的颅内压值、血肿清除时间、血肿处残余血液量、美国国立卫生研究院卒中量表(NIHSS)评分进行分析比较。结果两针穿刺组术中清除血肿较容易,能有效降低颅内压。两针穿刺组血肿清除时间(117.42±14.52)h与单针穿刺组(142.00±29.66)h比较,差异有统计学意义(PvO.05)。术后第1天两组颅内压值均较高,但两针穿刺组较单针穿刺组低;术后第2、3天两组颅内压值均有所降低,但两针穿刺组降低程度更为理想(PvO.05)。两针穿刺组入院后1和2周,术后3个月、6个月和1年的NIHSS评分与单针穿刺组比较,均差异有统计学意义(PvO.05)。结论对中大量脑出血患者实施立体定向微创两针穿刺清除颅内血肿的方法能有效清除颅内血肿,降低颅内压,减轻大脑损害程度,改善患者预后。
Aim To study the effect of different number of puncture needles of stereotactic minimally invasive procedures on removing intracranial hematoma and reducing intracranial pressure.Methods Seventy・two patients with supratentorial hypertensive cerebral hemorrhage of 30〜55 inL will be divided into a study group and a control group according to different surgical methods,36 cases in each group.The patients in study group were selected by using two needle puncture of stereotactic minimally invasive procedures to remove intracranial hematoma(ICH);the patients in the control group were selected by using single needle puncture of stereotactic minimally invasive procedures to remove ICH.ICP sensor without drainage tube will be placed in hematoma edge to monitor intracranial pressure in both groups patients.Intracranial pressure value,the removal time of hematoma,the volume of residual blood,and the National Institutes of Health Stroke Scale(NIHSS)of the patients in the two groups will be compared.Results It is easier to remove hematomas during operation in the study group and can effectively reduce intracranial pressure・The removal time of hematoma in the study group was(117.42±14.52)hours,the removal time of hematoma in the control group was(142.00±29.66)hours,the difference was statistically significant(P<0.05).The intracranial pressure in both groups was higher on the first day after operation,but the study group was lower than the control group,the intracranial pressure of the two groups decreased on the second and third day after operation,but the decrease degree of the intracranial pressure of the study group was more satisfactory,the difference was statistically significant(P<0.05).The NIHSS of the study group at 1 week after admission,2 weeks after admission,3 months after operation,6 months after operation and 1 year after operation,were compared with the control group,the difference were statistically significant(P<0.05)・Conclusion The method of removing ICH by two needle puncture of stereotactic minima
作者
宋安军
伍国锋
任思颖
王丽琨
秦冠南
毛远红
SONG An-jun;WU Guo-fen g;REN Si-ying;WANG Li-kun;QIN Guan-nan;MAO Yuan-hong(Department of Emergency Neurology,the Affiliated of Guizhou Medical University,Guiyang 550004,China)
出处
《中国临床神经科学》
2019年第6期664-670,共7页
Chinese Journal of Clinical Neurosciences
基金
贵阳市科技计划项目(编号:筑科合同[2017]30-11号)
关键词
立体定向微创
降低颅内压
临床对照研究
血液量
颅内血肿清除
穿刺针数
NIHSS评分
单针穿刺
cerebral hemorrhare
intracranial pressure monitoring
stereotactic minimally invasive procedures
two needle puncture
National Institutes of Health Stroke Scale
