额入法血肿穿刺及对侧侧脑室穿刺引流治疗重型基底节脑出血破入脑室的效果评价

Therapeutic effects of punctures and drainage of hematoma through frontal region and drainage from contralateral lateral ventricle for treatment of severe intracerebral hemorrhage in the basal ganglion ruptured into the cerebral ventricles

目的探讨额入法血肿穿刺及对侧侧脑室穿刺引流治疗重型基底节脑出血破入脑室的疗效。方法采用额入法血肿穿刺及对侧侧脑室穿刺引流治疗18例重型基底节脑出血破入脑室患者,同时选择同期住院并与之相匹配的20例拒绝微创术只行内科保守治疗的患者作为对照。结果微创组治疗的总有效率(77.8%)及其存活者生活质量(62.34±22.15)均显著高于内科治疗组(P<0.05)。肺部感染(22.2%)、电解质紊乱(16.7%)及脑疝(11.1%)发生率均显著低于内科治疗组(P<0.05)。结论额入法血肿穿刺及对侧侧脑室穿刺引流是一种治疗重型基底节脑出血并破入脑室的有效方法。

Objective To study the clinical efficacy of punctures and drainage of hematoma through frontal region and drainage from contralateral lateral ventricle for treatment of severe intracerebral hemorrhage in the basal ganglion ruptured into the cerebral ventricles. Methods Punctures and drainage of hematoma through frontal region and drainage from contralateral lateral ventricle was performed in 18 patients（minimally invasive group） with severe intracerebral hemorrhage in the basal ganglion ruptured into the cerebral ventricles and only medical treatment was used in 20 matched cases（medical treatment group） with the same disease for control. Results The total effective rate（77.8%） and the Barthel Indexes（62.34±22.15） in the minimally invasive group were significantly higher than those in the medical treatment group（P0.05）.In addition,the incidences of cerebral herniation（11.1%）,electrolyte disturbances（16.7%） and pulmonary infection（22.2%） in the minimally invasive group were significantly lower than those in the medical treatment group（P0.05）. Conclusions Punctures and drainage of hematoma through frontal region and drainage from contralateral lateral ventricle can be a safe and effective method for treatment of severe intracerebral hemorrhage in the basal ganglion ruptured into the cerebral ventricles.