Department of Neurosurgery, the first hospital of Hebei Medical University, Shijiazhuang 050031, China; Neurosurgery staff room, the first clinical college of Hebei Medical University, Shijiazhuang 050031, China.
Department of Neurosurgery, the first hospital of Hebei Medical University, Shijiazhuang 050031, China.
J Stroke Cerebrovasc Dis. 2024 Nov;33(11):107956. doi: 10.1016/j.jstrokecerebrovasdis.2024.107956. Epub 2024 Aug 24.
To evaluate the efficacy of stereotactic soft-channel and hard-channel aspiration in the treatment of primary brainstem hemorrhage.
The clinical data of 146 patients with primary brainstem hemorrhage at the First Hospital of Hebei Medical University from August 2014 to August 2023 were analyzed. At admission, 146 patients were divided into soft-channel group or hard-channel group using a random number table method. Sixty-five patients were treated with stereotactic soft-channel aspiration, and 81 patients were treated with stereotactic hard-channel aspiration. The amount of residual hematoma was evaluated by head CT immediately after the operation, and the length of the indwelling drainage tube was recorded. Survival status at 30d after the operation and treatment outcome (mRS score and GOS score) at 90d after the operation were also recorded. The amount of residual hematoma immediately after the operation, the length of the indwelling drainage tube after the operation, the mortality rate and the treatment outcome were compared between the two groups.
There was significant difference in the mortality rate 30d after the operation (41.5% vs. 14.8%, χ = 20.192, P = 0.035) between stereotactic soft-channel aspiration and stereotactic hard-channel aspiration for brainstem hemorrhage. The hard-channel group had a higher survival rate. There was significant difference in the treatment outcome at 90 days after treatment (18.5% vs. 32.1%, χ = 4.783, P = 0.047). The hard-channel group showed better treatment outcomes 90 days after surgery.
Stereotactic hard-channel aspiration for primary brainstem hemorrhage has greater clearance efficiency than soft-channel aspiration and can significantly reduce patient mortality and improve treatment outcomes. Stereotactic hard-channel aspiration is a safe and effective method for treating primary brainstem hemorrhage.
评价立体定向软通道和硬通道抽吸治疗原发性脑干出血的疗效。
分析 2014 年 8 月至 2023 年 8 月河北医科大学第一医院收治的 146 例原发性脑干出血患者的临床资料。入院时，采用随机数字表法将 146 例患者分为软通道组或硬通道组。65 例患者采用立体定向软通道抽吸治疗，81 例患者采用立体定向硬通道抽吸治疗。术后即刻行头颅 CT 评估残余血肿量，并记录留置引流管长度。记录术后 30d 生存状态及术后 90d 治疗结局（mRS 评分和 GOS 评分）。比较两组术后即刻残余血肿量、术后留置引流管长度、死亡率及治疗结局。
立体定向软通道抽吸与立体定向硬通道抽吸治疗脑干出血术后 30d 死亡率分别为 41.5%和 14.8%，差异有统计学意义（χ = 20.192，P = 0.035），硬通道组死亡率较低，生存率较高。两组术后 90d 治疗结局比较差异有统计学意义（18.5%比 32.1%，χ = 4.783，P = 0.047），硬通道组术后 90d 治疗结局较好。
立体定向硬通道抽吸治疗原发性脑干出血较软通道抽吸清除效率更高，可明显降低患者死亡率，改善治疗结局。立体定向硬通道抽吸是治疗原发性脑干出血安全有效的方法。
