导航辅助钻孔引流术治疗高血压性基底节区出血的临床研究

目的探讨神经导航辅助下钻孔引流术治疗高血压性基底节区又出血的效果。方法神经导航辅助下钻孔引流术治疗高血压性基底节区出血患者33例，术中经额叶沿基底节区血肿长轴穿刺，术后将尿激酶注入血肿腔溶解引流残余血肿。结果导航系统误差为（1．12±0．34）mm。手术血肿清除率为（52±21）％，使用尿激酶后24h血肿清除率为（70±11）％、48h血肿清除率为（78±9）％。术后再出血率为3％（1／33）。术后随访3月，良好13例，中残12例，重残3例，植物生存3例，死亡2例。结论神经导航引导下经额叶沿血肿长轴穿刺治疗高血压性基底节区出血能够明显提高血肿清除率、缩短留管时间、减少手术副损伤。

Clinical effects of neuronavigator-assited burr hole drainage on hypertensive basal ganglia hemorrhage

Objective To explore the clinical effects of neuronavigator-assisted burr hole drainage on hypertensive basal ganglia region hemorrhage. Method The clinical data of 33 patients with hypertensive basal ganglia region hemorrhage, who underwent burr hole drainage from January, 2011 to July, 2012, were analyzed retrospectively. Results The mean error of the neuronavigation system is （1.12± 0.34） ram. The mean removal rate of the hemotomas was （52± 21）%. The removal rate of hemotomas was （70± 11）% and （78 ± 9）% respectively 24 and 48 hours after using urokinase. The rebleeding rate after the operation was 3% （1/33）. The mean time of the operation was （87-＋31） minutes and the mean length of hospital stay was （13.6±3.5） days. One patient had intraoperative cerebral hemorrhage again and died 5 day later. The other 32 patients were followed up for 3 months, according to GOS score, 13 patients had good recovery, 12 were moderately disabled, 3 severely disabled, 3 survived vegetatively and 2 died. Conclusion The neuronavigation is helpful to increase in the removal rate of hemotomas and decrease in the surgery-related injury in patients with hypertensive basal ganglia hemorrhage.