CT指导下基底节区脑出血锥颅抽吸治疗有效性与安全性的临床研究

Security and validity of stereotaxic aspiration of ganglionic intracerebral hemorrhage under computerized tomography

目的 了解CT指导下基底节区脑出血锥颅抽吸治疗的有效性与安全性 ,并对影响锥颅治疗脑出血患者预后的一些相关因素进行分析。方法 回顾性分析 2 0 0 0年 12月 1日～ 2 0 0 2年 6月 1日我院病案首页数据库中所有CT指导下行锥颅抽吸治疗的基底节出血病例以及同期符合锥颅抽吸治疗手术指征而行内科保守治疗的基底节出血患者。在患者出血后30d进行疗效评定。采用等级资料秩和检验、χ2 检验、方差分析以及多元判别分析进行统计学分析。结果 锥颅抽吸与内科保守治疗基底节出血疗效上有显著性差异。χ2 检验表明 ,两组患者在死亡率上有显著性差异 (P <0 0 5 )。同时 ,单因素检验表明锥颅手术时间为影响脑出血锥颅抽吸治疗患者 30d预后的危险因素 (P <0 0 5 ) ,但多元逐步判别分析显示脑出血后锥颅时间并不是影响生存的主要危险因素。结论 CT指导下基底节区脑出血锥颅抽吸治疗的有效性与安全性优于内科保守治疗。脑出血后锥颅治疗时间可能对患者预后存在一定的影响。

Objective To investigate the security and validity of stereotaxic aspiration,and explore the risk factors for prognosis in patients with ganglionic intracerebral hemorrhage treated with stereotaxic aspiration.Methods The medical records and CT scans of 113 patients with ganglionic intracerebral hemorrhage treated with stereotaxic aspiration and 91 patients without stereotaxic aspiration treatment were retrospectively reviewed.The curative effect for all the patients were evaluated in 30 days after hemorrhage.Wilcoxon Signed Ranks Test,χ 2 test,univariate and multivariate statistical analyse were adopted to analyse the results.Results The 30-day mortality for the 113 cases of ganglionic intracerebral hemorrhage treated with stereotaxic aspiration was 14 2%. Wilcoxon Signed Ranks Test and univariate analysis found that stereotaxic aspiration treatment excelled internal medicine treatment in the security and validity (P<0 05),and the time of stereotaxic aspiration was significantly correlated with 30-day outcome after hemorrhage (P<0 05).But multivariate discriminant analysis showed that the time of stereotaxic aspiration was not significantly independent predictors of 30-day outcome.Conclusion Stereotaxic aspiration treatment under computerized tomography excelled internal medicine treatment in the security and validity.The time of stereotaxic aspiration might be correlated with the outcome of patients treated with aspiration.