两种锥颅方式治疗自发性基底节小血肿效果比较

Comparison between curative effects of both the minimally invasive procedures through drilling skulls on small spontanerus hematomas in the basal ganglia regions

目的比较徒手定位锥颅引流和简易头皮定位锥颅引流治疗自发性基底节小血肿的效果。方法自发性基底节血肿患者67例,采用徒手定位锥颅引流42例,简易头皮定位锥颅引流25例,术后均给予尿激酶溶解血肿。比较两组的引流效果。结果徒手定位锥颅引流组与简易头皮定位锥颅引流组引流效果相比无明显差异(P>0.05),但徒手定位锥颅引流组置管时间明显延长(P<0.05)。结论对于小血肿徒手定位单孔引流疗效满意,但可能需要反复调整引流管。微创穿刺血肿腔引流加尿激酶冲洗简单易行,血肿清除率高,术后恢复好。

Objective To compare the curative effect of bare-handed location aspiration with that of the scalp marker-guided aspiration on the small spontaneous hematomas in the basal ganglia regions. Methods The clinical data of 67 patients with small spontaneous hematomas in the basal ganglion regions, of whom, 42 were treated by bare-hand location aspiration [the volume of the hematomas, （30.5 ＋_8.6） ml] and 25 by scalp marker-guided location aspiration [the volume of the hematomas, （32.1±9.5） ml], were analyzed retrospectively. All the patients were treated also by the fibrinolysis with urokinase. The curative effects were compared between both the groups. Results There were no significant differences in the residual hematoma volume 7 days after the aspiration and Barthel index 3 months after the aspiration between both the bare-handed location aspiration and scalp marker-guided location aspiration groups （P〉0.05）. The duration of the drainage [（5.4 ±2.6） days] in the scalp marker-guided location aspiration group was significantly shorter than that [（7.5±2.1） days] in the bare-handed location aspiration group （P〈0.05）. Conclusions The curative effect of the bare-handed location aspiration on the small spontaneous hematomas in the basal ganglia regions is similar to that of the scalp marker-guided location aspiration, but the placement of the drainage tube need being repeatedly adjusted. The curative effect of the microtraumatic aspiration including the bare-handed location and scalp marker-guided location aspiration followed by fibrinolysis on the small spontaneous hematomas in the basal ganglia regions is good.