CT引导下立体定向梯度减压术在重度脑出血术中的应用

Application of CT-guided stereotactic in severe cerebral hemorrhage craniotomy

目的:探讨CT引导下立体定位梯度减压术在重度脑出血手术治疗中的临床疗效。方法:选取重度脑出血患者129例,按收治时间将其分为治疗组(66例)和对照组(63例)。治疗组采用梯度减压法手术;对照组采用标准大骨瓣开颅术。所有患者均在CT引导立体定位下确定手术路径,采用格拉斯哥昏迷评分(GOS)预后评分进行评估,比较两组的GOS评分结果。结果:两组相比治疗组恢复良好率高于对照组,其差异有统计学意义(x2=5.97,P<0.05);病死率低于对照组,其差异有统计学意义(x2=4.58,P<0.05);手术并发症,治疗组脑膨出、迟发性血肿发生率均低于对照组,其差异有统计学意义(x2=5.21,4.01;P<0.05)。结论:CT引导立体定位梯度减压术能有效提高重度脑出血患者的手术疗效,且可降低术中、术后并发症,对改善患者预后具有积极的意义。

Objective：To investigate the clinical effects of CT-guided stereotactic ladder-type decompression technique in severe cerebral hemorrhage craniotomy.Methods： A total of 66 patients （treatment group） with severe cerebral hemorrhage, who were admitted to the hospital between Mar.2009 and Dec.2013, were treated with ladder-type decompression technique. The number of patients（control group） with severe cerebral hemorrhage is 63 ,who were admitted to the hospital between May.2004 and Dec.2008,treated with the standard large trauma craniotomy. The confirmation of operation path was by CT-guided stereotact.Results： By Glasgow Outcome Scale（GOS）,the good recovery rate of treatment group was higher than the control group（x2=5.97,P＆lt;0.05）, and death rate was lower than the control group（x2=4.58,P＆lt;0.05）. The incidence of intraoperative brain swelling in control group is higher than the treatment group, and the rate of delay hematoma was higher than the treatment group（x2=5.21,4.01, P＆lt;0.05）.Conclusion：Treatment with CT-guided stereotactic ladder-type decompression technique is effective on severe cerebral hemorrhage. It can decrease postoperative complications and improve prognosis.