神经导航精准定位微创治疗中小量高血压性基底节脑出血.pdf

第42 卷 第5 期 兰州大学学报（医学版） Vol.42 No.5 2016 年10 月 Journal of Lanzhou University （Medical Sciences ） Oct. 2016 文章编号：1000-2812 (2016) 05-0036-04 神经导航精准定位微创治疗中小量高血压性 基底节脑出血 龚 良，钱忠心，刘卫东，赵 鸿，赵明珠 上海市浦南医院 神经外科，上海 200125 摘要：目的目的探讨神经导航下经额穿刺血肿微创治疗高血压性脑出血的疗效。方法方法 对32 例伴有明显肢体活动障碍的高 血压性基底节区脑出血患者，选择血肿侧距离眉间8 ～10 cm、旁开中线2 ～3.5 cm 为穿刺点，根据CT 影像资料采用神 经导航辅助下经额部穿刺抽吸血肿。与同期28 例保守治疗患者进行比较，观察两组肢体功能障碍的变化及总体疗效。 结果结果 两组病例均无死亡，微创治疗组治疗2 周后肢体瘫痪改善率明显高于保守治疗组 （P 0.05 ），3 个月后进行临床 预后评价，微创治疗组功能恢复优于保守治疗组 （P 0.05 ）。结论结论 神经导航引导经额穿刺血肿微创治疗高血压性基底 节区脑出血能显著改善血肿对神经结构的损伤，提高疗效。 关键词：高血压；脑出血；神经导航；经额穿刺 中图分类号：R743.3 文献标识码：A doi ：10.13885/j.issn. 1000-2812.2016.05.007 Minimally invasive therapy for hypertensive cerebral hemorrhage in basal ganglia under neural navigation-assisted precise position Gong Liang, Qian Zhong-xin, Liu Wei-dong, Zhao Hong, Zhao Ming-zhu Department of Neurosurgery, Shanghai Punan Hospital, Shanghai 200125, China Abstract ：：Objective To investigate the effect of neuro-navigation transfrontal puncture on the therapy for hy- pertensive cerebral hemorrhage in basal ganglia. Methods 32 patients with limb movement inability from hy- pertensive cerebral hemorrhage of basal ganglia in Shanghai Punan Hospital from 2009.6-2014.6 received min- imally invasive puncture drainage under navigation guidance. The puncture site was located in the frontal re- gion 8~10 cm at distance ofglabellum on the hemorrhage side and adjacent to the midline 2 ~3.5 cm. The hema- toma was drainaged by neuro-navigation assisted frontal puncture according to the CT image, And compared the difference in the change as well as the overall effect of limb dysfunction between operation group and 28 cases of non-operation patients. Results No death was found in two groups. Early (2 weeks) improvement rate of limbs paralysis in minimally invasive therapy group was significantly