经额血肿穿刺引流术治疗基底节脑出血手术时机的选择探讨

Operation timing discussion of frontal hematoma puncture and drainage in the treatment of basal ganglia intracerebral hemorrhage

目的探讨经额血肿穿刺引流术治疗基底节脑出血的手术时机。方法将90例自发性基底节脑出血患者按发病后手术时机分为超早期组(<6h)、早期组(6～24h)及延期组(1～23d)各30例。3组患者均予经额血肿穿刺引流术,观察3组血肿清除率、脑水肿体积变化情况及手术并发症发生率。结果早期组和延期组血肿清除率高于超早期组,差异有统计学意义(P<0.05);治疗后,3组脑水肿体积均小于治疗前,且早期组脑水肿体积小于超早期组和延期组,差异均有统计学意义(P<0.05或P<0.01)。早期组并发症发生率低于超早期组和延期组,差异有统计学意义(P<0.01)。结论早期对基底节脑出血患者行经额血肿穿刺引流术可降低患者并发症发生率,改善患者脑水肿情况并加快其神经功能的恢复,值得临床推广用。

Objective To investigate the operation timing of frontal hematoma puncture and drainage in the treatment of basal ganglia intracerebral hemorrhage. Methods 90 cases patients with spontaneous basal ganglia intracerebral hemorrhage were randomly divided into ultra-early group （ 〈 6 hours）, early group （6 -24 hours） and extension group （ 1 -23 days） according to operation timing. Three groups were given frontal hematoma puncture and drainage, and observed hematoma clearance rate,the changes of brain edema volume and the complication occurrencerate. Results The hematoma clearance rate of early group and extension group were higher than that of ultra-early group, the difference was statistically significant （P 〈 0.05） ; After treatment, brain edema volume of 3 groups were smaller than before treatment, and early group was smaller than that of ultra-early group and extension group,the difference was statistically significant（P 〈0.05 or P 〈0.01 ）. The complica- tions occurrence rate of early group was lower than that of ultra-early group and extension group, the difference was statistically significant（P 〈 0. 01 ）. Conclusion Giving frontal hematoma puncture and drainage to patients with basal ganglia intracerebral hemorrhage can effectively lower the complications occurrence rate, improve the brain edema, and accelerate the recovery of neurological function, and worthy of clinical application.