穿刺术对壳核出血运动功能恢复的影响被引量：1

Influence of aspiration on motor recovery in putaminal hemorrhage.

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摘要目的研究CT引导下的简易立体定向穿刺术对高血压性壳核出血患者运动功能恢复的影响。方法 65例高血压性壳核出血（血肿量20～30ml，Ⅰ、Ⅱ、Ⅲa、Ⅳa型）患者随机分为两组。穿刺组39例行CT引导下的简易立体定向穿刺术；保守组26例保守治疗，以患者入院时格拉斯哥昏迷评分（GCS）、运动功能恢复阶段（BMRS）评定及术后1、6个月时的BMRS评定为指标观察临床疗效。结果穿刺组在术后1、6个月时，BMRS评定均好于保守组，差异有显著性（P〈0．01或P〈0．05），但差异性在减小。结论对于高血压性壳核出血，CT引导下的简易立体定向穿剌束，可加速患者早期运动功能的恢复。 Objective To study the influence of computed tomographic-guided stereotaetic aspiration on motor recovery in the hypertensive putaminal hemorrhage （HPH）. Methods 65 cases of HPH （ hematoma volume ranged from 20-30 ml, type Ⅰ ,Ⅱ , Ⅲ a and Ⅳa ） were randomly divided into two groups. 39 eases in aspiration group were treated surgically with simple CT-guidcd stcreotaetie aspiration, and 26 eases in conservative treatment group were treated conservatively. The outcomes of both groups were assessed in terms of Glaseow Coma Scale （ GCS ） on admission and Brunnstrom motor recovery stage （BMRS） and 1 or 6 months postoperative BMRS. Results BMRS was better in aspiration group than that in conservative group at 1 and 6 months after operation, with significant difference （ P 〈 0.01 or P 〈 0.05 for each ）. But after 6 months, the statistical difference between them groups were lessened. Condusion CT-guided stereotactic aspiration for HPH may accelerate motor recovery in early stage of HPH.

作者张向华王光弟马骥超夏吉勇艾泉山

机构地区北京友谊医院神经外科

出处《中国综合临床》北大核心 2006年第4期333-335,共3页 Clinical Medicine of China

关键词壳核出血立体定向穿刺术 BMRS Putaminal hemorrhage Stereotactie aspiration Brunnstrom motor recovery stage

分类号 R743.34 [医药卫生—神经病学与精神病学]

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1Batjer HH,Reisch JS,Allen BC,et al.Failure of surgery to improve outcome in hypertensive putaminal hemorrhage[J].Arch Neurol,1990,47(10):1 103-1 106.
2McKissok W,Richardson A,Taylor J.Primary intracerebral hemorrhage:a controlled trial of surgical and conservative treatment in 180 unselected cases[J].Lancet,1961,2(3):221-226.
3Teernstra OP,Evers SM,Lodder J,et al.Stereotactic treatment of intracerebral hematoma by means of a plasminogen activator:a multicenter randomized controlled trial (SICHPA)[J].Stroke,2003,34(4):968-974.
4Montes JM,Wong JH,Fayad PB,et al.Stereotactic computed tomographic-guided aspiration and thrombolysis of intracerebral hematoma:protocol and preliminary experience[J].Stroke,2000,31(4):834-840.
5Kanaya H,Yukawa H,Itoh Z.Grading and the indications for treatment in intracerebral haematomas of the basal ganglia (cooperative study in Japan).In:Pia HW,Langmaid C,Zierski J,et al.Spontaneous Intracerebral Haematomas.Advances in Diagnosis and Therapy[M].New York:Springer-Verlag,1980.268-274.
6Tyler D,Mandybur G.Interventional MRI-guided stereotactic aspiration of acute/subacute intracerebral hematomas[J].Stereotact Funct Neurosurg,1999,72(2-4):129-135.
7朱镛连.神经病学[M].北京：人民军医出版社,2001.167-168.
8Backlund EO.Controlled subtotal evacuation of intracerebral hematomas by stereotactic technique[J].Surg Neurolo,1978,9(2):99.
9Kandel EI.Stereotactic evacuation of spontaneous intracerebral hematomas[J].J Neuro Surg,1985,62(2):206.
10John M,Abrahams Maraia B,Torchia RN,et al.Perioperative assessment of coagulability in neurosurgical patients using thromboelastography[J].Surg Neurol,2002,58(1):5-12.