快速细孔微创钻颅置管引流治疗高血压基底节脑出血

Rapid pore cranial drilling and drainage treatment in hypertensive basal ganglia hemorrhage

摘要:

目的 探讨快速细孔微创钻颅置管引流术治疗高血压基底节脑出血（hypertensive basal ganglia hemorrhage，HBGH）的优点，并与传统开颅（conventional open craniotomy，COC）作对照研究。方法 回顾性分析了589例高血压基底节脑出血病人的临床资料，其中430例应用快速细孔钻颅器钻颅置管引流清除血肿，159例行开颅手术血肿清除。结果 穿刺组恢复良好者（ADL Ⅰ Ⅱ Ⅲ）306例（占88.44%），预后不良者（ADL Ⅳ Ⅴ级）40例（占11.56%），死亡84例，（占19.53%）。开颅组恢复良好者（ADLⅠⅡⅢ级）50例（占49.02%），预后不良占（ADL Ⅳ Ⅴ级）52例（占50.98%），死亡57例（占33.96%）。两组死亡率及恢复良好率相比具有统计学意义（P<0.05）。结论 快速细孔钻颅置管引流术是一种安全有效、简易经济、微创可行的治疗高血压脑出血的方法。是治疗高血压基底节脑出血，挽救患者生命、提高生活质量的有效手段。

Abstract:

Objective To analyze the advantages of rapid pore cranial drilling and drainage treatment on hypertensive basal ganglia hemorrhage(HBGH), comparing with conventional open craniotomy(COC). Methods We retrospectively studied the clinical dates of 589 HBGH patients, in which 430 cases were treated using rapid pore cranial drilling and drainage method (puncture group) and 159 cases with conventional open craniotomy (control group). Results In puncture group,good outcome was accomplished (ADL Ⅰ Ⅱ Ⅲ) in 306 patients (88.4%), poor outcome (ADL Ⅳ Ⅴ) in 40 patients (11.6%), and 84 patients died.(19.5%). In control group, the outcome was good (ADL Ⅰ Ⅱ Ⅲ)in 50 cases (49.0%), poor (ADL Ⅳ Ⅴ) in 52 cases (51.0%), and 57 cases died. (34.0%). There was distinctly statistical significance in clinical outcome between the two groups (P<0.05). The mortality and good outcome of minimal invasive group significantly better than that of COC groups. Conclusions For its safe, effective, simple, economic, minimally invasive feasible,the rapid pore cranial drilling and drainage is a valuable method in treatment of hypertensive basal ganglia hemorrhage.