摘要
目的观察锥颅穿刺抽吸术联合置管引流治疗临界量基底节脑出血的疗效。方法 95例自发性基底节脑出血量在20~30 mL患者随机分为手术组(53例)和保守组(42例)。手术组采用锥颅穿刺抽吸术联合置管引流治疗,保守组采用保守治疗,比较两组患者的CT影像学、神经相关功能评分、炎症因子、并发症差异。结果手术组未出现血肿增加,保守组中5例需行开颅血肿清除术。治疗后第7天,手术组血清炎症因子IL-1、TNF-α、C反应蛋白水平均低于保守组(P<0.01)。治疗后第28天,手术组NIHSS评分显著低于保守组(P<0.01)。两组并发症差异无统计学意义(P>0.05)。第6个月时手术组日常生活活动能力、格拉斯哥结局评分高于保守组(P<0.01或0.05)。结论锥颅穿刺抽吸术联合置管引流治疗能够降低临界量基底节脑出血患者的炎症因子水平,并改善预后。
Objective To observe the clinical efficacy of stereotactic aspiration in basal ganglia hemorrhage(BGH)with threshold quantity.Methods Ninety-five patients with spontaneous BGH(bleeding volume=20-30 mL)were randomly treated with stereotactic aspiration(observation group,n=53)and conservative management(control group,n=42).CT imaging,neurologic function score,inflammatory cytokines,and complications were compared between two groups.Results The hematoma enlargement was absent in observation group,while 5 patients underwent craniotomy in control group.Serum levels of inflammatory cytokines IL-1,TNF-α,and C-reaction protein were lower in observation group than in control group 7 days posttreatment(P<0.01).NIHSS score was lower in observation group than in control group 28 days posttreatment(P<0.01).There were no significant difference in complications between two groups(P>0.05).Activities of daily living and Glasgow outcome scale in observation group were superior to those in control group(P<0.01 or 0.05)at 6 months of follow up.Conclusion Stereotactic aspiration can improve prognosis and reduce levels of inflammatory cytokines in BGH with threshold quantity.
作者
欧海荣
覃木秀
龙霄翱
OU Hai-rong;QIN Mu-xiu;LONG Xiao-ao(Department I of Neurosurgery,Wuchuan People’s Hospital,Zhanjiang 524500,China;Department of Neurosurgery,Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,China)
出处
《广东医科大学学报》
2020年第5期579-581,共3页
Journal of Guangdong Medical University
基金
湛江市科技计划项目(No.2019B01052)。
关键词
基底节脑出血
锥颅穿刺抽吸术
保守治疗
basal ganglia hemorrhage
stereotactic aspiration
conservative treatment
