CAJ | 학술논문

目的对比微创立体定向单管穿刺与双管穿刺引流术治疗大量基底节区高血压脑出血疗效差异.方法回顾分析高血压脑出血行单管穿刺引流术100例和行双管穿刺引流术50例患者的临床资料,对血肿清除率、引流管时间、尿激酶注人次数、ICU住院时间、颅内感染率、日常生活能力(ADL)评分进行统计学分析.结果单管组血肿清除率为(89.50±1.89)％,双管组为(93.50±2.36)％,两组差异有统计学意义(P＜0.05);单管引流时间(5.31±1.86)d,双管引流时间(3.15±1.81)d,差异有统计学意义(P＜0.01);单管组注入尿激酶(5.31±1.23)次,双管组注入尿激酶(3.31±1.68)次,两组比较差异有统计学意义(P＜0.05);单管组ICU住院时间(7.36±2.45)d,双管组ICU住院时间(5.31±1.23)d,差异有统计学意义(P＜0.05);单管组颅内感染率为8％,双管组颅内感染率为4％,差异有统计学意义(P＜0.01);单管组穿刺道出血率为0％,双管组穿刺道出血率为6％,差异有统计学意义(P＜0.01);按ADL分级法评价患者预后:单管组Ⅰ级10例,Ⅱ级25例,Ⅲ级30例,Ⅳ级30例,Ⅴ级5例;双管组Ⅰ级7例,Ⅱ级15例,Ⅲ级20例,Ⅳ级6例,Ⅴ级2例,两组差异有统计学意义(P＜0.05).结论双管较单管穿刺引流具有血肿清除率高、尿激酶注入次数少、引流时间短、ICU住院时间短、颅内感染率低的优点,但穿刺道出血率较高.
목적 대비미창입체정향단관천자여쌍관천자인류술치료대량기저절구고혈압뇌출혈료효차이.방법 회고분석고혈압뇌출혈행단관천자인류술100례화행쌍관천자인류술50례환자적림상자료,대혈종청제솔、인류관시간、뇨격매주인차수、ICU주원시간、로내감염솔、일상생활능력(ADL)평분진행통계학분석.결과 단관조혈종청제솔위(89.50±1.89)％,쌍관조위(93.50±2.36)％,량조차이유통계학의의(P＜0.05);단관인류시간(5.31±1.86)d,쌍관인류시간(3.15±1.81)d,차이유통계학의의(P＜0.01);단관조주입뇨격매(5.31±1.23)차,쌍관조주입뇨격매(3.31±1.68)차,량조비교차이유통계학의의(P＜0.05);단관조ICU주원시간(7.36±2.45)d,쌍관조ICU주원시간(5.31±1.23)d,차이유통계학의의(P＜0.05);단관조로내감염솔위8％,쌍관조로내감염솔위4％,차이유통계학의의(P＜0.01);단관조천자도출혈솔위0％,쌍관조천자도출혈솔위6％,차이유통계학의의(P＜0.01);안ADL분급법평개환자예후:단관조Ⅰ급10례,Ⅱ급25례,Ⅲ급30례,Ⅳ급30례,Ⅴ급5례;쌍관조Ⅰ급7례,Ⅱ급15례,Ⅲ급20례,Ⅳ급6례,Ⅴ급2례,량조차이유통계학의의(P＜0.05).결론 쌍관교단관천자인류구유혈종청제솔고、뇨격매주입차수소、인류시간단、ICU주원시간단、로내감염솔저적우점,단천자도출혈솔교고.
Objective To investigate the efficacy of the minimally invasive stereotactic puncture and drainage of single and double tube for massive hypertensive intracerebral hemorrhage (ICH) in the basal ganglia.Methods A retrospective study of patients who had hypertensive ICH in the basal ganglia and underwent surgical treatment was conducted,including 100 patients with single tube drainage and 50 patients with double tube drainage.The clearance rate of hematoma,drainage tube indwelling time,urokinase injection times,ICU length of stay,intracranial infection rate,and activities of daily living (ADL) scores were statistically analyzed.Results The hematoma clearance rate was (89.50 ± 1.89) ％ in single tube group,and (93.50 ± 2.36) ％ in double tube group with the difference being statistically significant between two groups (P ＜ 0.05).The drainage tube indwelling time was (5.31 ± 1.86) days in single tube group,and (3.15 ± 1.81) days in double tube group with the difference being statistically significant between two groups (P ＜ 0.01).The urokinase injection times were (5.31 ± 1.23) in single tube group,and (3.31 ± 1.68) in double tube group with the difference being statistically significant between the two groups (P ＜ 0.05).The ICU length of stay was (5.31 ± 1.23) days in double tube group,and (7.36 ± 2.45) days in single tube group with the difference being statistically significant (P ＜ 0.05).The intracranial infection rate was 4％ in double tube group,and 8％ in single tube group with the difference being statistically significant between the two groups (P ＜ 0.01).The channel bleeding rate was 6％ in double tube group,and 0％ in single tube group with the difference being statistically significant between the two groups (P ＜0.01).According to ADL scores to assess the prognosis,there were 10 cases of stage Ⅰ,25 cases of stage Ⅱ,30 cases of stage Ⅲ,30 cases of stage Ⅳ,and 5 cases of stage Ⅴ in single tube group,and there were 7 cases of stage Ⅰ,15 cases of stage Ⅱ,20 cases of stage Ⅲ,6 cases of stage Ⅳ,and 2 cases of stage Ⅴ in double tube group,respectively.There were statistically significant differences between two groups (P ＜ 0.05).Conclusion Double tube drainage is characterized by higher hematoma clearance rate,less urokinase injection times,a shorter stay of ICU,less intracerebral infection rate than the single-tube puncture and drainage,but suffers from higher rate for puncture path bleeding.