简易立体定向穿刺引流治疗自发性基底核区脑出血

Simple stereotactic puncture drainage for spontaneous basal ganglia hemorrhage

目的研究简易立体定向系统治疗自发性基底核脑出血的疗效。方法回顾性分析44例自发性基底核脑出血病人的临床资料,其中采用简易立体定向系统结合软通道穿刺引流30例(立体定向组),采用简易标记定位锥颅血肿引流术14例(标记定位组),比较两组的置管准确率、血肿清除率、尿激酶用量、Barthel评分等指标。结果立体定向组引流管置管准确率为86.7%,平均尿激酶使用量为(7.07±4.92)×10~4U、单位体积残留血肿尿激酶用量为(0.27±0.19)×10~4U/ml,均明显优于标记定位组(P <0.05),但两组间血肿抽吸清除率、Barthel评分差异无统计学意义(P>0.05)。结论简易立体定向系统治疗自发性基底核区脑出血定位准确、简便有效,优于简易标记定位穿刺引流。

Objective To study the effect of simple stereotactic puncture drainage on spontaneous basal ganglia hemorrhage. Methods Clinical data of 44 spontaneous basal ganglia hemorrhage patients were analyzed retrospectively, including 30 patients undergoing simple stereotactic system and soft channel puncture drainage as stereotactic group and 14 undergoing simple mapping and puncture drainage of cone cranial hematoma as mapping group. The accuracy of catheter placement, evacuation rate of hematoma, dosage of urokinase and Barthel score were compared between the two groups. Results The accuracy of catheter placement, average dosage of urokinase, urokinase dosage of residual hematoma per unit volume in stereotactic group were 86.7%,（7.07 ± 4.92） × 10^4 U,（0.27 ±0.19） × 10^4 U/ml respectively, which were significantly better than mapping group（P〈0.05）. There were no difference in evacuation rate of hematoma and Barthel score between the two groups（P〉0.05）. Conclusions The simple stereotactic puncture drainage is accurate, simple and effective in the treatment of spontaneous basal ganglia hemorrhage, thus being superior to the simple mapping puncture drainage.