CT引导下立体定向穿刺引流对少量基底节脑出血的临床应用价值探讨

Clinical Value of CT-guided Stereotactic Puncture and Drainage for Small Amount of Basal Ganglia Cerebral Hemorrhage

目的探讨CT引导下立体定向穿刺引流对少量基底节脑出血的临床应用价值。方法90例患者依据治疗方式的不同将患者分为保守治疗组(n=47)、手术治疗组(n=43),手术治疗组进行CT引导下立体定向穿刺引流治疗,保守治疗组给予内科药物,观察两组临床效果。结果90例基底节脑出血手术前CT主要图像表现为高密度影,常合并同侧脑组织及脑室结构受压移位,43例患者出现中线结构偏移,颅内可见游离气体影。穿刺术后CT复查图像主要表现为高密度影不同程度缩小,病灶毗邻低密度包绕影减轻,CT值下降,颅内游离气体影消失。两组并发症发生率比较无统计学意义(P>0.05);保守治疗组住院时间高于手术治疗组(P<0.05)。治疗后手术治疗组NIHSS评分明显低于保守治疗组(P<0.05)。结论CT辅助引导下立体定向穿刺引流可有效提高少量基底节脑出血的临床效果,降低患者并发症发生率,复查CT可及时观察血肿吸收情况。

Objective To investigate the clinical value of CT-guided stereotactic puncture and drainage for small amount of basal ganglia cerebral hemorrhage.Methods 90 patients were divided into conservative treatment group (n=47) and surgical treatment group (n=43).The operation group was treated with CT-guided stereotactic puncture and drainage,while the conservative group was treated with medical drugs.The clinical effects of the two groups were observed.Results The main CT images of 90 patients with basal ganglia intracerebral hemorrhage before operation showed high density shadow,often accompanied by compression and displacement of ipsilateral brain tissue and ventricular structure.43 patients had deviation of midline structure and intracranial free gas shadow. After puncture,the CT images showed that the high density shadow was reduced in varying degrees,the shadow surrounded by low density adjacent to the lesion was reduced, the CT value was decreased,and the intracranial free gas shadow disappeared.There was no significant difference in the incidence of complications between the two groups(P >0.05).The hospitalization time of conservative treatment group was longer than that of surgical treatment group (P<0.05).After treatment,the NIHSS score of the surgical treatment group was significantly lower than that of the conservative treatment group (P<0.05).Conclusion CT-assisted stereotactic puncture and drainage can effectively improve the clinical effect of a small amount of cerebral hemorrhage in basal ganglia and reduce the incidence of complications.Re-examination of CT can timely observe the absorption of hematoma.