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电磁导航引导下血肿穿刺引流术治疗高血压基底节区脑出血的临床疗效

The Clinical Efficacy of Electromagnetic Navigation-Guided Hematoma Puncture Drainage in Patients with Hypertensive Basal Ganglia Hemorrhage.

作者信息

Wu Ruhong, Qin Huaping, Cai Zhonghai, Shi Jia, Cao Jiachao, Mao Yumin, Dong Bo

机构信息

Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City, China.

Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City, China.

出版信息

World Neurosurg. 2018 Oct;118:e115-e122. doi: 10.1016/j.wneu.2018.06.137. Epub 2018 Jun 26.

Abstract

OBJECTIVE

To investigate the clinical efficacy of navigation-guided minimally invasive surgery in patients with hypertensive basal ganglia hemorrhage.

METHODS

A total of 64 patients with hypertensive basal ganglia hemorrhage were enrolled in this retrospective study. They were divided into a navigation group and a traditional group based on surgical approaches. The data for the 2 groups of patients were analyzed with regard for the hematoma clearance rate, duration of surgery, duration of hospitalization, Glasgow Outcome Scale score at discharge, Barthel index score at 6 months, and postoperative complication rates for rebleeding and pneumonia.

RESULTS

There were no significant differences in basic characteristics between the 2 groups (P > 0.05). The hematoma clearance rate was significantly lower in the navigation group (49.18 ± 16.76%) than in the traditional group (84.29 ± 6.91%, P < 0.01). The duration of surgery and duration of hospitalization were significantly shorter in the navigation group (55.00 ± 11.89 minutes and 24.25 ± 7.1 days, respectively) than in the traditional group (156.38 ± 47.9 minutes and 32.63 ± 9.8 days, respectively; both P < 0.01). There were also significant differences between the 2 groups in Glasgow Outcome Scale scores (P = 0.006). The Barthel index scores were significantly greater in the navigation group (73.13 ± 18.76) than in the traditional group (57.63 ± 26.63, P < 0.05). There were no significant differences between the 2 groups in the complication rates (P > 0.05).

CONCLUSIONS

Under certain conditions, compared with standard craniotomy and hematoma evacuation, navigation-guided hematoma puncture aspiration and catheter drainage is simple, effective, and safe as a treatment for hypertensive basal ganglia hemorrhage.

摘要

目的

探讨导航引导下微创手术治疗高血压性基底节区脑出血患者的临床疗效。

方法

本回顾性研究共纳入64例高血压性基底节区脑出血患者。根据手术方式将他们分为导航组和传统组。分析两组患者的血肿清除率、手术时间、住院时间、出院时格拉斯哥预后评分、6个月时Barthel指数评分以及再出血和肺炎的术后并发症发生率。

结果

两组患者的基本特征无显著差异(P>0.05)。导航组的血肿清除率(49.18±16.76%)显著低于传统组(84.29±6.91%,P<0.01)。导航组的手术时间和住院时间(分别为55.00±11.89分钟和24.25±7.1天)显著短于传统组(分别为156.38±47.9分钟和32.63±9.8天;均P<0.01)。两组患者的格拉斯哥预后评分也存在显著差异(P=0.006)。导航组的Barthel指数评分(73.13±18.76)显著高于传统组(57.63±26.63,P<0.05)。两组患者的并发症发生率无显著差异(P>0.05)。

结论

在一定条件下,与标准开颅血肿清除术相比,导航引导下血肿穿刺抽吸及导管引流术治疗高血压性基底节区脑出血简便、有效且安全。

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