定位导向双靶点双通道锥颅治疗高血压脑出血的疗效分析

doi:10.3969/j.issn.1005-6483.2019.08.014

摘要/Abstract

摘要： 目的观察应用握持式颅脑穿刺进行定位导向双靶点双通道锥颅治疗基底节区高血压脑出血临床疗效及安全性。方法基底节区高血压脑出血病人58例，均利用握持式颅脑穿刺定位导向方法治疗，根据治疗方法不同分为实验组和对照组。实验组15例，行双靶点双通道锥颅微创穿刺置管引流，对照组43例，行单通道穿刺置管引流，比较两组治疗效果。结果两组患者一般资料比较差异无统计学意义（P＞0.05）。51例患者均成功穿刺，引流管均置入理想靶点；两组均无穿刺过程中再出血，实验组术后平均置管时间（3.1±0.6）天，术后血肿清除率87.4%，NICU住院时间（3.8±0.8）天，平均住院时间（10.6±1.6）天；对照组术后平均置管时间（4.4±0.8）天，术后血肿清除率81.2%，NICU住院时间（5.5±1.3）天，平均住院时间（16.6±3.3）天；实验组平均置管，NICU住院，住院时间较对照组均显著缩短（P＜0.05）。两组均无颅内感染病例发生。6个月随访，实验组预后良好率66.67%，对照组预后良好率72.09%，差异无统计学意义（P＞0.05）。结论定位导向双点双通道锥颅治疗基底节区高血压脑出血简单可行，穿刺成功率高，较单通道穿刺相比手术风险无明显增加，但血肿引流效率更高，能降低NICU及总住院时间。

关键词: 双靶点, 双通道, 锥颅, 高血压脑出血, 疗效

Abstract: Objective To observe the clinical efficacy and safety of location-guided double-point and double-channel intracranial puncture in the treatment of hypertensive cerebral hemorrhage in basal ganglia.Methods 58 cases of hypertensive cerebral hemorrhage in basal ganglia were treated by location-guided intracranial puncture and orientation.15 cases in the experimental group were treated with double-target and double-channel minimally invasive puncture and catheter drainage，while 43 cases in the control group were treated with single-channel puncture and catheter drainage.The clinical data and therapeutic effects of the two groups were summarized and analyzed.Results There was no significant difference in general data between the two groups（P>0.05）.51 patients were successfully punctured and the drainage tube was placed into the ideal target; there was no bleeding during puncture in both groups.The average indwelling time of the experimental group was（3.1±0.6）d，the clearance rate of hematoma after operation was 87.4%，the hospitalization time of NICU was（3.8±0.8）d，and the average hospitalization time was（10.6±1.6）d.The average indwelling time of the control group was（4.4±0.8）d，the clearance rate of hematoma after operation was 81.2%， the average hospitalization time of NICU was（5.5±1.3）d，and the average hospitalization time was（16.6±3.3）d.The average indwelling time，hospitalization time and NICU time of experimental group was significantly shorter than that of control group（P<0.05）.No intracranial infection occurred in both groups.Six months follow-up showed that the good prognosis rate of the experimental group was 66.67%，while that of the control group was 72.09%.There was no significant difference（P>0.05）.Conclusion Location-guided double-target and double-channel intracranial puncture is simple and feasible for the treatment of hypertensive intracerebral hemorrhage.The success rate of puncture is high.Compared with single-channel puncture，the risk of operation is not significantly increased，but the efficiency of hematoma drainage is higher，which can reduce NICU and total hospital stay，and is conducive to early rehabilitation of patients.

Key words: double target, double channel, intracranial puncture, hypertensive intracerebral hemorrhage, clinical efficacy

陈迎春, 尧小龙, 别毕洲, 汪志忠, 冯娟娟, 张纯, 李欢欢, 盛柳青, 李俊. 定位导向双靶点双通道锥颅治疗高血压脑出血的疗效分析[J]. 临床外科杂志, 2019, 27(8): 674-676.

CHEN Yingchun, YAO Xiaolong, BIE Bizhou, et al.. Analysis of clinical efficacy of location-oriented double-target and double-channel intracranial puncture in the treatment of hypertensive intracerebral hemorrhage[J]. JOURNAL OF CLINICAL SURGERY, 2019, 27(8): 674-676.

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