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目的总结立体定向穿刺引流基底节区血肿的手术方法及技巧。方法回顾性分析2014年1月~2015年12月立体定向不同靶点穿刺引流治疗基底节区血肿30例患者的临床资料,手术靶点分别选择在血肿前段(A组)、血肿后段(B组)、血肿中心(C组)。结果 30例患者均达到预期穿刺靶点,术后穿刺通道出血2例,血肿扩大1例,术后序贯尿激酶引流冲洗治疗,血肿清除平均时间分别是血肿前段组(A组)3.5天、血肿后段组(B组)2.5天、血肿中心组(C组)3天。3组血肿清除时间对比无显著差异(P≥0.05)。结论立体定向穿刺引流治疗基底节区血肿损伤小、并发症少、术后患者反应轻、血肿廓清时间短、住院时间短和费用低,是一种较理想的治疗幕上高血压脑出血的方法。手术穿刺靶点只要在血肿范围内就可以达到引流和减压目的。
Objective To summarize the surgical methods and techniques of stereotactic drainage of basal ganglia hematomas. Methods The clinical data of 30 patients with basal ganglia hematoma treated with different stereotactic targets by puncture and drainage from January 2014 to December 2015 were retrospectively analyzed. The surgical targets were selected in the anterior hematoma (A group), posterior hematoma (B) Group), hematoma center (C group). Results All the 30 patients achieved the expected puncture target. Two cases of bleeding after puncture channel and one case of hematoma enlargement were treated by sequential urokinase drainage and flushing. The average hematoma clearance time was 3.5 days in the anterior hematoma group (A group) Hematoma posterior segment group (B group) 2.5 days, hematoma center group (C group) for 3 days. There was no significant difference between the three groups in the time of hematoma removal (P> 0.05). Conclusion Stereotactic drainage is a better method to treat supratentorial hypertensive cerebral hemorrhage because of less injury, fewer complications, less postoperative reaction, shorter clearing time of hematoma, shorter hospitalization time and lower cost. . As long as the target of surgical puncture in the hematoma range can achieve drainage and decompression purposes.