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| Curative effect of stereotactic surgery in the treatment of hypertensive intracerebral hemorrhage |
| LIU Jialin WANG Gesheng LI Nannan ZHOU Yujia LIU Xiaohan DONG Fei LI Yajing PENG Peng |
| Department of Neurosurgery, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China |
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Abstract Objective To investigate the efficacy of CT stereotactic minimally invasive soft channel catheterization combined with urokinase in the treatment of hypertensive intracerebral hemorrhage. Methods The clinical data of 80 patients with hypertensive intracerebral hemorrhage admitted to Dongfang Hospital, Beijing University of Chinese Medicine from October 2012 to May 2017 was analyzed retrospectively. 40 cases of patients taken conservative treatment of internal medicine were set as control group, 40 cases of patients treated with CT stereotactic minimally invasive soft channel catheterization combined with urokinase were set as observation group. The activities of daily living (ADL), Glasgow outcome score (GOS), Glasgow coma scale (GCS), Barthel index in the two groups were compared. Results There was no statistically significant difference of the improvement of ADL grading between the two groups (P ＞ 0.05). The scores of GOS after treatment for 30, 90 days, and the scores of GCS after treatment for 5 days in the observation group were all higher than those of control group, and the difference of Barthel index before and after treatment for 30 days in the observation group was higher than that of control group, the differences were all statistically significant (all P ＜ 0.05). The incidence of complications in the observation group was lower than that of control group, the difference was statistically significant (P ＜ 0.05). Conclusion The effect of CT stereotactic microvascular catheterization combined with urokinase in the treatment of hypertensive intracerebral hemorrhage is significantly better than the conservative treatment, which can improve the activities of daily living, reduce complications, with a positive clinical use value.
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[1] 陈建华.高血压脑出血立体定向手术与内科保守治疗预后对比分析[J].中国实用神经疾病杂志，2010，13（1）：20-22.
[2] 邱戈，杨志明，胡帮洪，等.立体定向手术对高血压脑出血的疗效及预后影响因素分析[J].中国实用神经疾病杂志，2015，18（17）：3-6.
[3] 陈立新.微创手术在高血压脑基底节区出血的治疗体会[J].现代预防医学，2012，14（1）：14-15.
[4] 杨学，陈劲草，张雪梅.小骨窗开颅与立体定向置管抽吸治疗基底节区高血压脑出血的临床研究[J].中西医结合心脑血管病杂志，2016，14（13）：1472-1474.
[5] 徐鸿飞.小骨窗与立体定向血肿抽吸治疗高血压脑出血临床效果对比研究[J].中国医学创新，2014，11（23）：133-135.
[6] Thanvi BR，Sprigg N，Munshi SK，et al. Advances in spontaneous intracerebral haemorrhage [J]. Int J Clin Pract，2012，66（6）：556-564.
[7] 崔杰，王启华，黄春刚，等.立体定向微创穿刺置管引流与开颅血肿清除手术治疗基底节区脑出血疗效对比观察[J].中国综合临床，2011，27（11）：1185-1187.
[8] 王建清，盖延延，卞留贯，等.立体定向血肿抽吸术治疗高血压脑出血的Meta分析[J].医学临床研究，2012，29（9）：1665-1667.
[9] 张永森，王玉峰，赵家鹏，等.基底节区高血压脑出血手术方式的选择的分析[J].中国医疗前沿，2012，7（10）：42.
[10] 龙新泉.脑肿瘤立体定向靶向微创手术的临床效果观察[J].中国医学创新，2013，10（31）：89-90.
[11] 李严风，王增保，叶刚，等.微创血肿穿刺抽吸引流术联合尿激酶治疗高血压脑出血的疗效观察[J].中国实用医药，2013，8（2）：17-18.
[12] Wang X，Liang H，Xu M，et al. Comparison between transsylvian-transinsular and transcortical-transtemporal approach for evacuation of intracerebral hematoma [J]. Acta Cirurgica Brasileira，2013，28（2）：112-118.
[13] 蒋永祥，毕科.微创穿刺与内科治疗用于基底节区脑出血的近期临床效果比较[J].吉林医学，2014，22（20）：4416.
[14] 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.
[15] 丁友彬.高血压脑出血CT立体定向手术36例临床探讨[J].中国现代药物应用，2015，9（20）：61-62.
[16] 江敏.高血压脑出血患者内科保守治疗与立体定向手术预后比较[J].中国实用神经疾病杂志，2014，17（7）：113-114.
[17] 徐廷伟，周毅，秦永芳.立体定向手术技术治疗高血压脑出血[J].中华神经医学杂志，2013，12（12）：1271-1273.
[18] 郭瑞宏.立体定向手术治疗高血压脑出血手术指征探讨[J].中国卫生标准管理，2016，7（2）：73-74.
[19] 郭卫东.高血压脑出血立体定向手术与内科保守治疗疗效对比分析[J].中华高血压杂志，2011，19（12）：1200.
[20] 祖兴旺.64排CT导引经颞下入路立体定向治疗重症脑干出血（8例临床分析）[J].立体定向和功能性神经外科杂志，2011，24（6）：371-372，379. |
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