立体定向穿刺术治疗基底节中等量脑出血的临床研究

Clinical study on effects of stereotactic puncture in treatment of moderate amount of cerebral hemorrhage in basal ganglia

目的探讨立体定向微创治疗基底节区中等量脑出血的疗效。方法选取基底节区中等量出血患者80例,随机分为立体定向组和保守组各40例,立体定向组根据术前CT影像行立体定向穿刺术及血肿腔尿激酶注射清除血肿;保守组给予内科药物治疗。结果立体定向组的肺部感染发生率(10.0%)低于保守组(27.5%)(P <0.05);治疗后3 d及2 w,立体定向组血肿清除率均明显高于保守组(P <0.05);立体定向组的住院时间明显短于保守组(P <0.05);治疗后6个月,立体定向组的日常生活能力(ADL)分级良好率(40.0%)显著高于保守组(17.5%)(P <0.05)。结论脑立体定向微创手术治疗基底节区中等量脑出血,在近期及远期疗效上优于保守治疗,且能减少感染并发症,促进患者恢复。

Objective To explore the effects of stereotactic minimally invasive puncture in the treatment of moderate amount of cerebral hemorrhage in basal ganglia. Methods A total of 80 patients with moderate amount of cerebral hemorrhage in basal ganglia were selected and randomly divided into a stereotaetie group and a conservative group （n=40, respectively）. The conservative group was treated with medical medicine. Results The incidence of pulmonary infection in the stereotaetie group （10.0%） was lower than that in the conservative group （27.5%） （P 〈 0.05）; three days and two weeks after the treatment, the hematoma clearance rate in the stereotaetie group was significantly higher than that in the conservative group （P 〈 0.05）; six months after the treatment, the good grading rate of the activities of daily living （ADL） （40.0%） was significantly higher than that in the conservative group （P 〈 0.05）. Conclusion The cerebral stereotaetie minimally invasive surgery has better short-term and long-term effects in the treatment of moderate amount of cerebral hemorrhage in basal ganglia, and can reduce infection complications and promote patient recovery.