不同穿刺点微创治疗高血压脑出血病人的效果比较

COMPARISON OF MINIMALLY INVASIVE TREATMENTS WITH DIFFERENT PUNCTURE POINTS IN TREATMENT OF HYPERTENSIVE CEREBRAL HEMORRHAGE

目的通过对高血压脑出血病人传统硬通道微创治疗方法和改良穿刺方法临床疗效进行比较,探讨Trolard和Labbe静脉对高血压脑出血微创治疗效果的影响。方法高血压脑出血病人257例,根据穿刺点部位的不同分为传统穿刺组(A组)123例、改良穿刺组(B组)134例两组,A组穿刺点位于Trolard和Labbe静脉区,B组穿刺点位于Trolard和Labbe静脉区之外。比较两组并发症的发生率。结果 B组病人硬膜下血肿或蛛网膜下隙出血的形成、静脉性水肿、静脉性梗死、失语、肢体偏瘫较A组少,其中两组间硬膜下血肿或蛛网膜下隙出血、静脉性水肿发生情况比较,差异有显著性(χ2=12.55、8.53,P<0.05)。结论高血压脑出血采用硬通道微创治疗穿刺点选择避开Trolard和Labbe静脉区,能明显减少穿刺术后并发症的发生。

Objective To compare the minimally invasive treatments with traditional puncture point（bleeding hard channel）and modified puncture point in the treatment of hypertensive cerebral hemorrhage,and to investigate the effects of Trolard and Labbe veins on the efficacy of minimally invasive treatment for hypertensive cerebral hemorrhage. Methods A total of 257 patients with hypertensive cerebral hemorrhage were divided into traditional puncture point group（group A,n=123）and modified puncture point group（group B,n=134）according to the location of the puncture point.In group A,the puncture points were in the area of Trolard and Labbe veins;in group B,the puncture points were outside of the area of Trolard and Labbe veins.The incidence of complications was compared between the two groups. Results Group B had lower incidence rates of subdural hematoma or subarachnoid hemorrhage,venous edema,venous infarction,aphasia,and hemiplegic limbs than group A,and there were significant differences in the incidence rates of subdural hematoma or subarachnoid hemorrhage and venous edema between the two groups（χ2=12.55,8.53;P 〈0.05）. Conclusion In minimally invasive treatment of hypertensive cerebral hemorrhage,the puncture point should not be in the area of Trolard and Labbe veins,so that the incidence of postoperative complications can be significantly reduced.