128层CT引导联合颅脑CTA在脑出血微创穿刺中的应用研究

Application of 128-slice CT Guided Combined Cranial CTA in Minimally Invasive Puncture of Cerebral Hemorrhage

目的:探讨128层CT引导联合颅脑CTA在微创穿刺治疗脑出血中的应用。方法:选取我院2017年1月到2017年12月收治的脑出血患者120例,并随机将其分为2组,每组60人。一组采用128层CT引导联合颅脑CTA对患者进行微创穿刺,设为观察组;另一组采用128层CT对患者进行微创穿刺。比较两组患者的手术成功率、术后72h血肿清除量、术后颅内出血例数、治疗后近期的格拉斯哥预后评分及病死率。结果:观察组患者的手术成功率为95%,对照组患者的手术成功率为63.3%,观察组患者手术成功率明显较高于对照组患者;观察组患者术后72h血肿清除量为(23.64±4.65)ml,对照组患者术后72h血肿清除量为(20.27±2.00)ml,观察组患者术后72h血肿清除量明显高于对照组患者;观察组患者治疗后近期的格拉斯哥预后评分高于对照组患者,两组比较差异具有统计学意义(P<0.05);观察组患者行微创穿刺手术后,出现2例脑脊液漏患者,1例颅内感染患者,观察组患者并发症发生率5%,对照组患者行微创穿刺手术后,出现5例脑脊液漏患者,4例颅内感染患者,对照组患者并发症发生率为15%,观察组患者并发症发生率明显低于对照组;观察组病死3例,对照组病死4例,两组患者的病死率比较差异无统计学意义。结论:采用128层CT引导联合颅脑CTA微创穿刺治疗脑出血,提高了微创穿刺手术的成功率,提高了患者的生活质量和预后情况,对于脑出血患者的治疗效果更好,减少了术后并发症的发生率,值得临床应用及推广。

Objective:To explore the application of 128 slice CT guidance combined with brain CTA in the treatment of cerebral hemorrhage by minimally invasive puncture.Methods:120 patients with cerebral hemorrhage admitted to our hospital from January 2017 to December 2017 were randomly divided into two groups,60 in each group.One group was treated with 128 slice CT guidance combined with brain CTA for minimally invasive puncture,and the other group was treated with 128 slice CT for minimally invasive puncture.The success rate of operation,the volume of hematoma clearance 72 hours after operation,the number of cases of intracranial hemorrhage after operation,Glasgow prognosis score and mortality rate in the near future were compared between the two groups.Results:the success rate of operation in the observation group was 95%,and that in the control group was 63.3%.The success rate of operation in the observation group was significantly higher than that in the control group.The clearance of hematoma in the observation group was(23.64±4.65)ml at 72 h,that in the control group was(20.27±2.00)ml at 72 h,and that in the observation group was significantly higher than that in the control group After treatment,the Glasgow prognosis score of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05)Among the 4 patients with intracranial infection,the incidence of complications in the control group was 15%,and the incidence of complications in the observation group was significantly lower than that in the control group;3 cases died in the observation group and 4 cases died in the control group,and there was no significant difference between the two groups.Conclusion:128 slice CT guidance combined with brain CTA minimally invasive puncture can improve the success rate of minimally invasive puncture operation,improve the quality of life and prognosis of patients.It is better for the treatment of patients with cerebral hemorrhage and reduce the incidence of postoperative complications.It is worthy of clinical application and promotion.