摘要
目的观察脑出血患者保守治疗及微创血肿清除术治疗后磁共振波谱(MRS)的变化,从影像学方面探讨微创血肿清除术对脑出血患者脑水肿的影响及临床价值。方法20例高血压脑出血患者随机分为两组。微创血肿清除手术组(微创组):10例脑出血患者于发病后6～24h内接受简易立体定向微创血肿清除术治疗;对照组:10例脑出血患者接受内科保守治疗,所有病例均于发病后9～11d行常规MRI及MRS检查。结果对磁共振谱线进行分析,对照组血肿周围NAA/Cr与对侧相对应区域的NAA/Cr值差异有显著性(P<0.01),前者较后者降低(12.6±7.4)%,其中4例可见到明确的乳酸峰。微创组血肿周围NAA/Cr与对侧相对应区域的NAA/Cr值差异无显著性(P>0.05),且乳酸峰显示不明显。结论微创血肿清除术能有效清除血肿,可显著改善脑出血后脑水肿形成,脑出血患者微创血肿清除术组与对照组MRS的变化从影像学方面佐证了微创血肿清除术效果。神经影像学不仅提供了形态结构上的依据,还提出了功能上的客观指标。
【Objective】 To observe the changes of the intracerebral hemorrhage （ICH） patient with conservative therapy and micro-damage puncture by magnetic resonance spectroscopy （MRS）, trying to explore the effect of brain edema and clinical value of the ICH patients with micro-damage puncture from the neuroimaging aspect. 【Methods】 Twenty patients with ICH were divided into two groups randomly. Micro-damage puncture group （micro-damage puncture group）： ten patients accepted the stereo-orientation micro-damage puncture during 6 to 24 hours after symptom onset; control group： ten patients accepted the conservative therapy. All patients did the MRI and MRS in the 9 to 11 days after symptom onset.【Results】 The result was analyzed by magnetic resonance spectroscopy. The difference of the perihematomal NAA/Cr value between the focus side and the contralateral corresponding side was significant in the control group （P 0.01）, and the focus side decreased （12.6 ± 7.4）% as compared with the contralateral corresponding side, four could be seen the obvious Lac peak among all patients. There was no statistically significant difference in the perihematomal NAA/Cr value between the focus side and the contralateral corresponding side in the micro-damage puncture group （P 0.05）, no patient showed the Lac peak. 【Conclusion】 The micro-damage puncture can clear the hematoma effectively and reduce the formation of brain edema significantly after ICH, the changes of MRS between the micro-damage puncture group and the control group proved the effect of the micro-damage puncture from the neuroimaging aspect. The neuroimaging not only provided the evidence of the morphostructure but also the objective index of the function.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2010年第5期756-759,共4页
China Journal of Modern Medicine
基金
广州市医药卫生科技一般引导项目
(No.2009-YB-153)
关键词
脑出血
微创血肿清除术
磁共振波谱
intracerebral hemorrhage
micro-damage puncture
magnetic resonance spectroscopy
