2种立体定向双靶点置管引流术治疗基底节区椭圆形脑出血的比较

Comparison of Two Ways of Double-Target Stereotactic Drainage Pipe in the Treatment of Oval Basal Ganglia Hemorrhage

目的比较2种立体定向双靶点置管引流术的优缺点。方法在基底节区椭圆形脑出血的治疗中,经椭圆形的前上1/4和后下1/4(或前下1/4和后上1/4)单管置管引流40例;分别以椭圆形的前上1/3和后下1/3(或前下1/3和后上1/3)为靶点,双管置管引流40例。比较2组手术时间、术中出血量、拔管时间、术后3个月ADL评分。结果2组手术均顺利完成。双管组手术时间(110±18)min显著长于单管组(70±21)min(t=-9.147,P=0.000),双管组术中出血量(8±3)ml显著多于单管组(4±2)ml(t=-7.017,P=0.000),双管组拔管时间(4.5±1.5)d显著长于单管组(3.0±1.5)d(t=-4.472,P=0.000)。术后3个月ADL评分2组差异无显著性(Z=0.005,P=0.500)。结论治疗基底节区椭圆形脑出血,与双管双靶点置管引流手术相比,单管双靶点置管引流手术近期疗效相同,但手术时间短,术中出血少,血肿清除快,是一种较好的治疗方法。

Objective To compare the strong and weak points of two ways of double-target stereotactic drainage pipe（s）.Methods Totally 80 patients with oval basal ganglia hemorrhage were treated by using double-target with stereotactic drainage pipe.In 40 cases,one pipe through one fourth of the frontal and upper oval as well as the latter and nether oval（or one fourth of the frontal and nether oval as well as the latter and upper oval） was placed;In the other 40 cases,two pipes were introduced at the level of one third of the frontal and upper oval as well as the latter and nether oval（or one third of the frontal and nether oval as well as the latter and upper oval）.The operation time,intraoperative blood loss,time of pipe（s） withdrawal and the ADL score determined 3 months after the operations were compared between the two groups.Results The operations were completed successfully in both the groups.The operation time of the two pipes group [（110±18） min] are significantly longer than that in the one pipe group [（70±21） min,t=-9.147,P=0.000].The intraoperative blood loss of the two pipes group [（8±3） ml] are significantly more than that in the one pipe group [（4±2） ml,t=-7.017,P=0.000].The time of pipe（s） pulling out in the two pipes group [（4.5±1.5） d] are significantly longer than that in the one pipe group（3.0±1.5） d,t=-4.472,P=0.000].The ADL scores determined at 3 months after the operation were not significantly different between the two groups（Z=0.005,P=0.500）.Conclusions In the treatments of oval basal ganglia hemorrhage by double-target stereotactic drainage pipe（s）,two-pipe and one-pipe methods show similar short-term effects,but the two-pipe method results in significantly shorter operation time,less intraoperative blood loss and rapidly cleared hematoma.