单管与双管置入治疗基底节区脑出血的对比分析

The comparied analysis of drainage via a single tube and double tubes in treatment of basal ganglia hemorrhage

目的比较单纯经颞钻孔引流和经颞联合经额钻孔引流的优缺点。方法针对基底节区椭圆形(或肾形)脑出血,分别采用单纯经颞钻孔引流(单管组,28例)以及经颞联合经额钻孔引流(双管组,30例)血肿。对两组的手术时间、拔管时间、术后合并症及3个月后G O S分级进行比较。结果两组手术均顺利完成。双管组手术时间(93.13±10.19)m in,明显长于单管组的(57.29±11.06)m in(t=-12.851,P=0.000);双管组拔管时间(2.78±0.78)d,明显早于单管组的(4.34±0.97)d(t=6.729,P=0.000);双管组肺部或颅内感染率13.3%,明显低于单管组的32.1%(χ2=5.087,P=0.024)。两组术后出血增多、消化道出血及3个月后G O S分级比较差异无显著性(P>0.05)。结论治疗基底节区椭圆形(或肾形)脑出血,双管置入引流法与单管法相比,虽然手术时间相对较长,但明显增加引流速率,缩短引流时间且降低感染发生率,有利于缩短病人的住院时间和减少治疗费用。

【Objective】 To compare the advantages and disadvantages of drilling and drainage via a single tube and double tubes in the treatment of basal ganglia hemorrhage.【Methods】 Among 58 patients with oval or renal-shaped hematomas in the basal ganglia,28 cases were placed with a single tube in the tempora for puncture drainage（the single tube group）,while other 30 cases were placed two tubes in the frontal as well as in the temporal（the double tubes group）.The operation time,decannulation time,postoperative complications and 3 months＇ GOS grading in two groups were compared.【Results】 Operations were performed successfully in both groups.The operation time in the double tubes group was significantly longer than that in the single tube group [（93.13 ± 10.19） min vs（57.29 ± 11.06） min;t =-12.851,P =0.000].The decannulation time in the double tubes group was obviously earlier than that in the single tube group [（2.78 ± 0.78） d vs（4.34 ± 0.92） d;t= 6.729,P =0.000].The rate of pulmonary or intracranial infection in the double tubes group was obviously lower than that in the single tube group（13.3% vs 32.1%;χ2 = 5.087,P =0.024）.There was no significant difference in the postoperative intracerebral or gastrointestinal bleeding and 3 months＇ GOS grading between two groups.【Conclusion】 In the puncture drainage treatment of basal ganglia hemorrhage,though the placement of double tubes would take longer operation time,it can obviously increase the drainage rate,shortened the drainage time and lower the infection rate when compared to the placement of a single tube,which may result in reduced hospitalization time and reduced treatment costs.