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微创液化引流术治疗高血压性壳核出血的临床研究

Clinical study on minimally invasive liquefaction and drainage of intracerebral hematoma in the treatment of hypertensive putamen hemorrhage.

作者信息

Liang Ke-Shan, Ding Jian, Yin Cheng-Bin, Peng Li-Jing, Liu Zhen-Chuan, Guo Xiao, Liang Shu-Yu, Zhang Yong, Zhou Sheng-Nian

机构信息

Department of Neurology, Qilu Hospital of Shandong University and Brain Science Research Institute, Shandong University, Jinan, Shandong, China.

Department of Neurology, Pingyi Branch of Qilu Hospital, Shandong University, Pingyi, Shandong, China.

出版信息

Technol Health Care. 2017 Dec 4;25(6):1061-1071. doi: 10.3233/THC-170950.

Abstract

OBJECTIVE

This study aims to compare the curative effect of different treatment methods of hypertensive putamen hemorrhage, in order to determine an ideal method of treatment; and to explore the curative effect of the application of soft channel technology-minimally invasive liquefaction and drainage of intracerebral hematoma in the treatment of hypertensive putamen hemorrhage.

METHODS

Patients with hypertensive cerebral hemorrhage, who were treated in our hospital from January 2015 to January 2016, were included into this study. Patients were divided into three groups: minimally invasive drainage group, internal medical treatment group and craniotomy group. In the minimally invasive drainage group, puncture aspiration and drainage were performed according to different hematoma conditions detected in brain CT, the frontal approach was selected for putamen and intracerebral hemorrhage, and drainage was reserved until the hematoma disappeared in CT detection. Drug therapy was dominated in the internal medical treatment group, while surgery under general anesthesia was performed to remove the hematoma in the craniotomy group.

RESULTS

Post-treatment neurological function defect scores in minimally invasive drainage group and internal medical group were 16.14 ± 11.27 and 31.43 ± 10.42, respectively; and the difference was remarkably significant (P< 0.01). Post-treatment neurological function defect scores in the minimally invasive drainage group and craniotomy group were 16.14 ± 11.27 and 24.20 ± 12.23, respectively; and the difference was statistically significant (P< 0.05). There was a remarkable significant difference in ADL1-2 level during followed-up in survival patients between the minimally invasive drainage group and internal medical treatment group (P< 0.01), and there was a significant difference in followed-up mortality between these two groups (P< 0.01).

CONCLUSION

Clinical observation and following-up results revealed that minimally invasive drainage treatment was superior to internal medical treatment and craniotomy.

摘要

目的

本研究旨在比较高血压性壳核出血不同治疗方法的疗效,以确定理想的治疗方法;并探讨软通道技术-微创脑内血肿液化引流术在高血压性壳核出血治疗中的疗效。

方法

纳入2015年1月至2016年1月在我院治疗的高血压脑出血患者。患者分为三组:微创引流组、内科治疗组和开颅手术组。微创引流组根据脑CT检测到的不同血肿情况进行穿刺抽吸引流,壳核及脑内出血选择额部入路,引流至CT检测血肿消失。内科治疗组以药物治疗为主,开颅手术组在全身麻醉下进行手术清除血肿。

结果

微创引流组和内科治疗组治疗后神经功能缺损评分分别为16.14±11.27和31.43±10.42;差异有统计学意义(P<0.01)。微创引流组和开颅手术组治疗后神经功能缺损评分分别为16.14±11.27和24.20±12.23;差异有统计学意义(P<0.05)。微创引流组与内科治疗组存活患者随访期间ADL1-2水平差异有统计学意义(P<0.01),两组随访死亡率差异有统计学意义(P<0.01)。

结论

临床观察及随访结果显示,微创引流治疗优于内科治疗和开颅手术。

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