Jiang Hao, Yan Min, Chen Mantao, Huang Kaiyuan, Wang Hao, Wang Yadong, Zhou Qian, Zhu Yu, Fang Zebin, Weng Yuxiang, Zhang Luyuan, Wu Fan, Wen Liang, Zhan Renya
Department of Neurosurgery, The First Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, China.
Department of Emergency Medicine, The First Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, China.
World Neurosurg. 2025 May;197:123845. doi: 10.1016/j.wneu.2025.123845. Epub 2025 Feb 28.
The present study aimed to compare hematoma evacuation efficiency between multipoint and single-point aspiration techniques and to investigate the influence of distinct aspiration techniques on functional outcomes in patients undergoing stereotactic catheter aspiration for intracerebral hemorrhage (ICH).
Clinical and imaging data from 102 consecutive patients diagnosed with ICH who underwent stereotactic catheter aspiration and thrombolysis were collected. Multivariate regression analyses were performed to evaluate the effects of catheter aspiration techniques on residual hematoma volume after aspiration alone (postaspiration volume), residual hematoma volume at the end of treatment (EOT volume), and functional independence at 6 months (modified Rankin Scale score ≤2).
The median postaspiration volume of the multipoint group (n = 52) was 11.9 mL, significantly smaller than 19.8 mL of the single-point group (n = 50; P < 0.001). The multipoint group was administered fewer urokinase doses and had a higher rate of achieving functional independence, although no statistical significance was observed in the univariate analyses. Linear regression analyses revealed that the multipoint aspiration technique was independently associated with lower postaspiration (P < 0.001) and EOT (P = 0.016) volumes. After controlling for group differences and disease severity variables, binary regression analyses identified multipoint aspiration as an independent factor favoring functional independence 6 months after ICH (P = 0.042).
Compared with the single-point technique, the multipoint aspiration technique significantly increased immediate hematoma reduction through aspiration alone and independently contributed to a lower EOT volume, which may favor 6-month functional independence in individuals who experience ICH.
本研究旨在比较多点穿刺与单点穿刺技术清除血肿的效率，并探讨不同穿刺技术对接受立体定向导管抽吸治疗脑出血（ICH）患者功能结局的影响。
收集102例连续诊断为ICH并接受立体定向导管抽吸和溶栓治疗患者的临床和影像数据。进行多因素回归分析，以评估导管抽吸技术对单纯抽吸后残余血肿体积（抽吸后体积）、治疗结束时残余血肿体积（EOT体积）以及6个月时功能独立性（改良Rankin量表评分≤2）的影响。
多点组（n = 52）抽吸后体积中位数为11.9 mL，显著小于单点组的19.8 mL（n = 50；P < 0.001）。多点组尿激酶使用剂量较少，功能独立性实现率较高，尽管单因素分析未观察到统计学意义。线性回归分析显示，多点穿刺技术与较低的抽吸后体积（P < 0.001）和EOT体积（P = 0.016）独立相关。在控制组间差异和疾病严重程度变量后，二元回归分析确定多点穿刺是有利于ICH后6个月功能独立性的独立因素（P = 0.042）。
与单点技术相比，多点穿刺技术通过单纯抽吸显著提高了即刻血肿清除率，并独立导致较低的EOT体积，这可能有利于ICH患者6个月时的功能独立性。
