JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2017, Vol. 55 ›› Issue (5): 61-65.doi: 10.6040/j.issn.1671-7554.0.2016.1439

Previous Articles     Next Articles

Treatment of 68 cases of moderate volume of hypertensive intracerebral hemorrhage with free hand technique of minimally invasive puncture of the soft channel under CT orientation

WANG Weijun, ZHOU Ningquan, WANG Chao   

  1. Department of Neurosurgery, The Peoples Hospital of QianNan, Duyun 558000, Guizhou, China
  • Received:2016-11-04 Online:2017-05-10 Published:2017-05-10

PDF (PC)

121

Abstract: Objective To explore the efficacy of mini-invasive surgical treatment of moderate volume of hypertensive intracerebral hemorrhage. Methods The clinical data of 158 cases of hypertensive intracerebral hemorrhage(20- 40 mL)treated during Nov. 2011 and June 2015 were retrospectively analyzed. Of all patients, 68 underwent minimally invasive surgery(mini-invasive group), and 90 received non-surgical treatment(non-surgical group). The patients were followed up for 1 month. The mortality, hematoma evacuation time, and score of National Institutes of Health Stroke Scale were compared between the 2 groups. Results The mortality was 2.90% in the mini-invasive group, and 16.88% in the non-surgical group, with significant difference between the 2 groups(P<0.05). The hematoma evacuation time was 5±2.1 days in the mini-invasive group, and 21±3.5 days in the non-surgical group, with significant difference between the 2 groups(P<0.05). One month after treatment, the NIHSS score in the mini-invasive group was significantly lower than that in the non-surgical group (P<0.01). Conclusion Mini-invasive surgical treatment of moderate volume of hypertensive intracerebral hemorrhage is reliable, with short hematoma evacuation time and low mortality.

Key words: Hypertensive intracerebral hemorrhage, Minimally invasive surgery, Computed Tomography, Free hand puncture, Soft channel technique

CLC Number: 

  • R743.34
[1] Balami JS, Buchan AM. Complications of intracerebral haemorrhage[J]. Lancet Neurol, 2012, 11(1): 101-118.
[2] Steiner T, Bosel J. Options to restrict hematoma expansion after spontaneous intracerebral hemorrhage[J]. Stroke, 2010, 41(2): 402-409.
[3] Feigin VL, Lawes CM, Bennett DA, et al. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: A systematic review[J]. Lancet Neurol, 2009, 8(4): 355-369.
[4] Mendelow AD, Gregson BA, Femandes HM, et al. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the International Surgical Trial in Intracerebral Haemorrhage(STICH): a randomised trial[J]. Lancet, 2005, 365(9457): 387-397.
[5] 王维军, 周宁全, 杨华. 35例基底节区高血压脑出血术后再出血的多因素分析[J]. 贵州医药, 2013, 37(12): 1084-1086.
[6] Van Asch CJ, Luitse MJ, Rinkel GJ, et al. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: A systematic review and metaanalysis[J]. Lancet Neurol, 2010, 9(2): 167-176.
[7] 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国脑出血诊治指南(2014)[J]. 中华神经科杂志, 2015, 48(6): 435-444.
[8] Mendelow AD, Gregson BA, Rowan EN, et al. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas(STICHⅡ): a randomised trial[J]. Lancet, 2013, 382(9890): 397-408.
[9] Vespa PM, Martin N, Zuccarello M, et al. Surgical trials in intracerebral hemorrhage[J]. Stroke, 2013, 44( 1): 79-82.
[10] 黄欣, 金晶, 黄红光. 去骨瓣减压术并发症分析[J]. 中华创伤杂志, 2011, 27(5): 403-405. HUANG Xin, JIN Jing, HUANG Hongguang. Complications secondary to decompressive craniectomy[J]. Chinese Journal of Trauma, 2011, 27(5): 403-405.
[11] 左光银, 于宏伟, 袁玉会, 等. 不同术式治疗高血压脑出血的疗效比较[J]. 中国医科大学学报, 2012, 41(6): 565-567. ZUO Guangyin, YU Hongwei, YUAN Yuhui, et al. Comparison of different operative methods for hypertensive intracerebral hemorrhage treatment[J]. Journal of China Medical University, 2012, 41(6): 565-567.
[12] 王维军, 杨华. 微创软通道治疗高血压脑出血85例的临床分析[J]. 中国医药科学, 2014, 4(20): 31-33. WANG Weijun, YANG Hua. Clinical analysis on 85 cases of hypertensive cerebral hemorrhage with minimally invasive soft channel technology[J]. China Medicine & Pharmacy, 2014, 4(20): 31-33.
[13] 何建青, 刘斌, 蔡学见, 等. 神经内镜辅助小骨窗开颅治疗老年高血压脑出血[J]. 中华神经外科杂志, 2012, 28(2): 199-202.
[14] 张金锋, 陈金寿, 陈建彬, 等. 微创理念对手术治疗高血压基底节脑出血预后的影响(附57例报道)[J].中华神经医学杂志, 2012, 11(4): 401-404.
[15] 王维军, 周宁全, 张文川, 等. 微创软通道技术治疗急性硬膜外血肿45例[J]. 中国微侵袭神经外科杂志, 2013, 18(2): 86.
[16] 孔文涛, 常小龙, 赵德清, 等. 微创手术治疗高血压脑出血[J]. 中华神经外科疾病研究杂志, 2011, 10(3): 276-277.
[17] Mould WA, Carhuapoma JR, Muschelli J, et al. Minimally invasive surgery plus recombinant tissue-type plasminogen activator for intracerebral hemorrhage evacuation decreases perihematomal edema[J]. Stroke, 2013, 44(3): 627-634.
[18] 吴修华, 杜杰. 微创颅内血肿清除术治疗高血压脑出血临床观察[J]. 山东大学学报(医学版), 2014, 52(s2): 84.
[19] 崔元孝, 唐茜茜, 郭章玉, 等. 微创血肿抽吸术后大鼠脑出血周围组织细胞凋亡的研究[J]. 山东大学学报(医学版), 2012, 5(5): 36-39. CUI Yuanxiao, TANG Qianqian, GUO Zhangyu, et al. Experimental research of apoptosis in rat tissue cells surrounding intracerebral hemorrhage after minimal hematoma aspiration[J]. Journal of Shandong University, 2012, 5(5): 36-39.
[20] Wang W. Minimally invasive surgical treatment of acute epidural hematoma: case series[J]. Biomed Res Int, 2016, 2016: 6507350. doi:10.1155/2016/6507350.
[1] WU Mengtao, WU Peng, YANG Yanfei, TANG Dianjun, MIAO Xiangling, LI Fandong. Application of CT venography in the diagnosis and treatment of recurrent lower extremity varicose veins [J]. Journal of Shandong University (Health Sciences), 2020, 1(9): 21-26.
[2] DAI Jianjian, YUAN Bing, ZHANG Ying, LIN Qi, YUAN Yuan, HAN Mingyong. CT-guided percutaneous 125I seed implantation brachytherapy in patients with stage Ⅲ non-small-cell lung cancer [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(2): 32-37.
[3] MENG Xiangshui, CHAI Xiangjun, MA Xiangxing, REN Qingguo, YANG Zhicheng. Value of CT and MRI in the treatment options of laryngeal cancer [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(10): 76-79.
[4] LIU Qing, SHANG Mengmeng, SUN Xiao, LI Jie, YANG Jie, SHI Dandan, NING Song. Effects of chemical composition of urinary stones on their acoustic shadowing [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(9): 19-23.
[5] LIU Lu, LI Rongrong, LIU Mengjun, ZHANG Yan, LIU Dongxu. Alveolar bone volume around upper incisors in adult patients with Class Ⅰ bimaxillary protrusion [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(8): 66-70.
[6] CHEN Xueling, WU Zizhong, LIU Dongxu, XIE Yongtao, GUO Tiantian, ZHANG Shijie. CBCT evaluation of the upper airway morphological changes in skeletal Class Ⅲ malocclusion patients using protraction and rapid maxillary expansion appliance [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(8): 71-78.
[7] FENG Xiaoyu, ZHANG Hongmei, CHE Xuanqiang, KANG Donghong. Therapeutic effects of human osteoblast-stimulating factor on osteoporosis of ovariectomized rats [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(7): 8-12.
[8] LI Wei， WANG Xin-yi， LI Ai-yin， DENG Kai， ZHANG Cheng-qi. Applications of CT spectral imaging and MRI in Achilles tendon rupture [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(4): 101-105.
[9] TIAN Min, YUAN Qian, CUI Yuan-xiao, ZHANG Qing-hua, TANG Qian-qian . Dynamic fluctuation of fibrinolytic activity in patients withmini-invasive hematoma aspiration [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2010, 48(10): 73-76.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd