New craniocerebral puncture locator combined with new head CT positioning patch assisted soft-channel puncture drainage treatment of hypertensive cerebral hemorrhage

doi:10.3877/cma.j.issn.2095-9141.2019.03.003

Abstract

Abstract:

Objective

To investigate the application and significance of the new type of craniocerebral puncture locator combined with new head CT positioning patch assisted soft-channel puncture drainage in the treatment of hypertensive cerebral hemorrhage.

Methods

Forty-five patients with hypertensive cerebral hemorrhage who underwent intracranial hematoma soft-channel puncture and drainage in the Department of Neurosurgery, Huzhou Central Hospital from January 2014 to December 2015 were selected as the control group, and the common ECG electrode slice was used to assist the puncture. On the other hand, 48 patients with hypertensive cerebral hemorrhage who underwent intracranial hematoma soft-channel puncture and drainage from January 2016 to July 2018 were selected as observation group. The new cranial puncture locator was combined with the new cranial CT positioning patch to assist the puncture. The patient’s surgical treatment effect and clinical prognosis were compared. At the same time, the economics and practicability of the new cranial puncture locator combined with the new cranial CT positioning patch-assisted positioning method were analyzed.

Results

Compared with the control group, the amount of bleeding in the observation group was less, the clearance rate of hematoma was higher and the difference was statistically significant (P<0.05). There was no significant difference between the two groups in terms of operation time (P>0.05). The hospital stay in the observation group was less than that in the control group. The prognosis at 3 months after surgery in the observation group was better than that in the control group and the difference was statistically significant (P<0.05).

Conclusion

The new craniocerebral puncture locator combined with new head CT positioning patch assisted soft-channel puncture drainage for the treatment of hypertensive cerebral hemorrhage can improve the accuracy of puncture positioning and intracranial hematoma clearance, reduce intraoperative blood loss. It can improve patients’ prognosis and improve the quality of life. So it is suitable to development in the primary hospitals.

Key words: Hypertension cerebral hemorrhage, Soft channel puncture drainage, Locator, Positioning patch

Hanxun Yao, Zhongzhou Su, Yue Zhou, Xiaobin Li, Liang Shen, Jie Xu. New craniocerebral puncture locator combined with new head CT positioning patch assisted soft-channel puncture drainage treatment of hypertensive cerebral hemorrhage[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2019, 05(03): 140-145.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhsjcswkdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-9141.2019.03.003

https://zhsjcswkdzzz.cma-cmc.com.cn/EN/Y2019/V05/I03/140

Figures/Tables 5

References 21

[1]	李晓斌,周跃.微创软通道穿刺引流治疗高血压脑出血[J].浙江医学, 2013, 35(22): 2007.
[2]	王维军,周宁全,王超. CT定位微创徒手穿刺软通道技术治疗中等量高血压脑出血68例[J].山东大学学报(医学版), 2017, 55(5): 61-65.
[3]	许光涛,赵宗茂,孔亚波,等. 3D-Slicer辅助定位微创软通道手术治疗老年高血压脑出血的临床研究[J].河北医科大学学报, 2018, 39(6): 658-661.
[4]	阮航,杨国平,罗明,等.导航联合内镜技术与小骨窗开颅术治疗脑出血的疗效比较[J].中华实验外科杂志, 2016, 33(11): 2573-2575.
[5]	姚瀚勋,夏学巍,肖晶,等.导航辅助神经内镜硬通道技术治疗基底节区高血压脑出血患者的临床疗效[J].重庆医学, 2018, 47(8): 1055-1057.
[6]	廖佳奇,涂勇,温小华,等.脑穿刺辅助架在颅内血肿穿刺引流手术中的应用[J].中华神经外科杂志, 2017, 33(11): 1169-1170.
[7]	Steiner T, Boesel J. Options to restrict hematoma expansion after spontaneous intracerebral hemorrhage[J]. Stroke, 2010, 41(2): 402-409.
[8]	黄斌,林云东,罗忠平,等.不同手术方式治疗高血压脑出血137例分析[J].国际神经病学神经外科学杂志, 2012, 39(4): 312-315.
[9]	常鹏飞,邬巍,左程,等.单双管微创穿刺引流术治疗大量基底节区高血压脑出血的疗效比较[J].中华实验外科杂志, 2015, 32(9): 2258-2260.
[10]	Mould WA, Carhuapoma JR, Muschelli J, et al. Minimally invasive surgery plus recombinant tissue-type plasminogen activator for intracerebral hemorrhage evacuation decreases perihematomaI edema[J]. Stroke, 2013, 44(3): 627-634.
[11]	杨进华,李泽禹,汪宇雄,等.两点三线交叉定位法在高血压性小脑血肿微创穿刺清除术中的应用效果评价[J].中国微侵袭神经外科杂志, 2018, 23(3): 115-118.
[12]	梁奇明,许峰,连立飞,等.以相对偏离度评估穿刺准确度对微创术治疗脑出血疗效的影响[J].华中科技大学学报(医学版), 2015, 44(3): 317-321.
[13]	蔚强,綦学强,吕俊生.立体定向钻孔引流术与小骨窗开颅术治疗老年高血压丘脑出血患者疗效观察[J].中华老年心脑血管病杂志, 2016, 18(6): 645-646.
[14]	Chang YH, Hwang SK. Frameless stereotactic aspiration for spontaneous intracerebral hemorrhage and subsequent fibrinolysis using urokinase[J]. J Cerebrovasc Endovasc Neurosurg, 2014, 16(1): 5-10.
[15]	李涵,郝东宁,马肃.神经导航辅助微创手术治疗老年高血压性基底节出血的临床疗效[J].卒中与神经疾病, 2018, 25(1): 64-67.
[16]	汪奇柏,郑超,何建国,等.高血压脑出血的高危因素调查及应用研究[J].中国临床医生杂志, 2017, 45(2): 50-53.
[17]	张曦,张健.基于双目立体视觉的手术导航脑部穿刺关键技术研究[J].计量与测试技术, 2018, 45(5): 54-57.
[18]	魏嘉良,董艳,候立军.高血压脑出血微创手术治疗进展[J].第二军医大学学报, 2015, 36(12): 1333-1338.
[19]	刘顶新,郭西良,张圣邦.定向软通道穿刺治疗高血压脑出血破入脑室[J].安徽医学, 2012, 33(8): 1029-1030.
[20]	沈峰,陈光烈,陈炜毅.简易定位辅助治疗高血压脑出血[J].浙江创伤外科, 2006, 11(4): 319-320.
[21]	王平振,邢伟,张蕊,等. CT定位引导下后颅窝钻孔软通道引流术治疗小脑出血[J].临床医学, 2016, 36(11): 69-70.

组别	例数	性别		年龄（岁）	病程（h）	体质量（kg）	血肿量（mL）	术前GCS评分（分）
组别	例数	男	女	年龄（岁）	病程（h）	体质量（kg）	血肿量（mL）	术前GCS评分（分）
观察组	48	33	15	52.97±6.01	12.00±3.36	62.6±9.15	37.82±8.75	8.06±2.25
对照组	45	28	17	52.37±6.88	10.47±3.08	67.5±8.74	36.08±6.64	7.28±2.11
t/χ²值	?	0.020		0.360	0.366	0.273	0.835	0.846
P值	?	0.887		0.720	0.716	0.786	0.682	0.499

组别	例数	性别		年龄（岁）	病程（h）	体质量（kg）	血肿量（mL）	术前GCS评分（分）
组别	例数	男	女	年龄（岁）	病程（h）	体质量（kg）	血肿量（mL）	术前GCS评分（分）
观察组	48	33	15	52.97±6.01	12.00±3.36	62.6±9.15	37.82±8.75	8.06±2.25
对照组	45	28	17	52.37±6.88	10.47±3.08	67.5±8.74	36.08±6.64	7.28±2.11
t/χ²值	?	0.020		0.360	0.366	0.273	0.835	0.846
P值	?	0.887		0.720	0.716	0.786	0.682	0.499

组别	例数	手术时间（h）	术中出血量（mL）	血肿清除率（%）	住院时间（d）
观察组	48	2.09±0.23	165.46±14.03	88.46±1.43	18.36±2.92
对照组	45	1.85±0.12	174.17±11.74	69.05±4.64	28.00±1.39
t值	?	-1.298	-56.253	-6.758	12.395
P值	?	0.310	0.001	0.017	0.004

组别	例数	手术时间（h）	术中出血量（mL）	血肿清除率（%）	住院时间（d）
观察组	48	2.09±0.23	165.46±14.03	88.46±1.43	18.36±2.92
对照组	45	1.85±0.12	174.17±11.74	69.05±4.64	28.00±1.39
t值	?	-1.298	-56.253	-6.758	12.395
P值	?	0.310	0.001	0.017	0.004

组别	例数	术后3个月ADL评分					预后良好率[例（%）]
组别	例数	I级	Ⅱ级	Ⅲ级	Ⅳ级	V级	预后良好率[例（%）]
观察组	48	6	16	15	9	2	37（77.1）
对照组	45	4	10	11	14	6	25（55.9）
χ²值	?	?	?	?	?	?	6.402
P值	?	?	?	?	?	?	0.019

Please choose a citation manager

Content to export