摘要
目的研究导致神经功能缺损的基底节小量出血的微刨治疗效果。方法对200例10-30ml伴有明显偏瘫等神经功能缺损的基底节出血患者（定向手术组）在出血6-72h内进行CT导向下的立体定向置管引流术，术后以尿激酶2万。5万单位每天2次血肿腔注入。并早期行高雎氧针刺及康复治疗。与同期80例未行手术治疗的基底节出血患者（对照组）进行对照研究。结果定向手术组血肿3d基本消失（残余量〈3ml）188例，大部消失10例，再出血行开颅手术2例。住院时间11-33d，平均19d。出院时恢复良好（日常生活活动能力分级为1-2级）140例（70％）。55例经3个月随访，恢复良好46例，总良好率为83．6％。对照组血肿消失时间18～33d，平均27d。住院时间21-45d，平均33d。出院时恢复良好28例（35．0％），轻残47例，重残3例，死亡2例。48例随访至3个月，恢复良好29例，总良好率为60．4％。两组功能恢复时间、恢复良好率、残疾率比较差异均有统计学意义（P〈0．05）。结论立体定向治疗基底节小量出血可显著加快和提高患者神经功能缺损的恢复，提高了患者的生活质量。
Objective To study the therapeutic effects of stereotaxis treatment on basal ganglia hemorrhage of small volume with neurological impairment. Methods Two hundred patients with basal ganglia hemorrhage（haematoma 10 to 30 ml） of small volume and neurological impairment were given stereotaxis treatment. All the operations were done 6 to 72 hours after hemorrhage （stereotaxis group）. Urokinase was given after operations. Hyperbaric oxygen and rehabilitation were done early. Eighty patients with basal ganglia hemorrhage but not surgery treatment as control group. Results The haematoma of 188 cases was evacuated completely and 10 cases was evacuated mosdy within 3 days. Two cases rebleeding patients were done craniotomy surgery. The hospitalization period was 11 to 33 days, average 19 days. Good recovery rate of neurological impairment was 70% when left hospital. Fifty-five cases were followed up 3 months. The complete recovery in 46 cases（ 83.6% ） in stereotaxis group. The haematoma of 80 cases in control group was absorbed during 18 to 33 days,average 27 days. The hospitalization period was 21 to 45 days,average 33 days. Good recovery rate of neurological impairment was 35.0% when discharged. Forty-eight cases were followed up 3 months. The total good recovery in 29 cases （60.4%）. There were significant differences between control group and stereotaxis group （P 〈 0.05）. Conclusion The treatment of stereotaxis on basal ganglia hemorrhage of small volume can further improve recovery of neurological impairment.
出处
《中国医师进修杂志（外科版）》
2007年第9期38-40,共3页
Chinese Journal of Postgraduates of Medicine
关键词
神经功能缺损
脑出血
少量
立体定向
Neurological impairment
Basal ganglia hemorrhage
Small volume
Stereotaxis
