Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, 256603, Shandong, China.
Department of Neurosurgery, Jinan People's Hospital, Jinan, 271100, Shandong, China.
Neurosurg Rev. 2023 May 5;46(1):104. doi: 10.1007/s10143-023-02015-2.
Basal ganglia hemorrhage, which is characterized by excessive incapacity charge and high mortality rates, is surgically treated by minimally invasive hematoma puncture and drainage. We aimed at determining the efficacy of laser-guided minimally invasive hematoma puncture and drainage for treatment of basal ganglia hemorrhage. A total of 61 patients with hypertensive basal ganglia hemorrhage were recruited at the Binzhou Medical University Hospital, between October 2019 and January 2021, and their clinical information retrospectively analyzed. Based on the surgical approach used, patients were assigned into either laser navigation or small bone window groups depending on the surgical approach. Then, we compared the operation times, intraoperative blood loss, clinic stay, Glasgow Outcome Score (GOS) rating at 30 days, Barthel index (BI) rating at 6 months, postoperative pneumonia incidences, and intracranial contamination complications between groups. Intraoperative blood loss, operation time, and sanatorium were significantly low in laser navigation group, relative to the small bone window group. At the same time, there were no significant differences between the groups with regard to postoperative hematoma volume, lung contamination, cerebrospinal fluid (CSF) leak, and intracranial contamination, as well as the 6-month BI and 30-day GOS rating. There were no deaths in either group. Compared with the traditional small bone window surgery, laser-guided puncture and drainage is a low-cost, accurate, and safe method for the treatment of basal ganglia hemorrhage, which is suitable for promotion in developing countries and economically underdeveloped areas.
基底节出血的特点是致残率高和死亡率高，通常采用微创血肿穿刺引流术进行治疗。本研究旨在探讨激光引导微创血肿穿刺引流术治疗基底节出血的疗效。回顾性分析 2019 年 10 月至 2021 年 1 月滨州市人民医院收治的 61 例高血压基底节出血患者的临床资料。根据手术方式分为激光导航组和小骨窗组。比较两组患者的手术时间、术中出血量、住院时间、术后 30 天格拉斯哥预后评分（GOS）、术后 6 个月日常生活活动能力量表（BI）评分、术后肺部感染发生率和颅内感染并发症。激光导航组患者的术中出血量、手术时间和住院时间明显少于小骨窗组。两组术后血肿量、肺部感染、脑脊液漏、颅内感染及术后 6 个月 BI 和术后 30 天 GOS 评分差异均无统计学意义。两组均无死亡病例。与传统小骨窗手术相比，激光引导穿刺引流术是一种治疗基底节出血的经济、准确、安全的方法，适合在发展中国家和经济欠发达地区推广。
