定量分析微创血肿引流术对脑出血血肿周围水肿的影响

Quantitative analysis of effect of stereotactic CT guided drain and aspiration of intracerebral hematoma on perihematomal edema

目的评价微创血肿引流术治疗对脑出血患者血肿量和血肿周围水肿、中线移位的影响。方法用图象分析系统定量比较出血量在30～60mL的基底节区脑出血患者保守治疗(67例)和微创治疗(65例)中24h内、10～14d、18～24d时血肿、血肿周围水肿、松果体和透明隔移位等的动态变化。结果10～14d时微创治疗组血肿量(9.77±6.21)mm3、血肿周围水肿(60.37±29.92)mm3均明显小于内科治疗组(25.90±8.90)mm3;(79.57±38.72)mm3,中线移位程度轻于内科组,差别有显著性(P<0.01)。结论微创血肿引流术可明显减少基底节区脑出血患者血肿量、脑水肿和中线移位的程度。

[ Objective ] To measure the changes of hematoma, perihematomal edema and shift of midline in the patient with basal ganglia area hemorrhage, and to evaluate the effects of surgery on brain edema. [Methods] Serial changes of hematoma, perihematomal edema and shift of eonarium and septum pellueidum within 24 hour, at 10-14 days and 18-24 days were accurately measured by image analysis system, 65 patients were treated by stereotaetie CT-guided drain and aspiration whose hematoma volume was between 30 ml and 60 ml. 67 identical typical patients treated by medicine were compared. [Results] The volume of hematoma and perihematoma edema in patients treated by surgery was far less than that in eases treated by medicine, so was the shift of medline, the difference bad prominent meaning （p〈0.05）. [Conclusion] Treatment by stereotaetie CT guided drain and aspiration could decrease the degree of hematoma, perihematomal edema and shift of midline in the patients with intraeerebral hemorrhage.