Hematoma puncture and catheter drainage assisted by a disposable stereotaxic locator for treating basal ganglia hemorrhage

Abstract

Objective To investigate the efficacy and safety of hematoma puncture and catheter drainage assisted by a disposable stereotaxic locator in the treatment of basal ganglia hemorrhage. Methods From January 2017 to May 2018, a total of 58 cases of basal ganglia hemorrhage with the hematoma volume of 25.52-39.98 ml were randomly divided into 2 groups: Locator group (N = 29) underwent hematoma puncture and catheter drainage assisted by a disposable stereotaxic locator and CT + laser group (N = 29) underwent hematoma puncture and catheter drainage assisted by CT positioning with the aid of a cross laser transmitter. Calculate the relative distance difference between preoperatively designed target and actual end on the horizontal plane of orbitomeatal line, coronal plane via bilateral porus acusticus externus and midsagittal plane. Record operation time, the numbers of intraoperative catheter placement and postoperative use of urokinase. Measure the volume of residual hematoma, calculate the proporation of residual hematoma before extubation. Record the occurrence rate of enlarged hematoma and intracranial infection. Results Locator group performed better than CT + laser group on puncture accuracy on the horizontal (t = -17.369, P = 0.000), coronal (t = -18.381, P = 0.000) and midsagittal plane (t = -13.540, P = 0.000) respectively. Locator group accomplished the puncture with less numbers of catheter placement (Z = -2.565, P = 0.010) and less use of urokinase after surgery (Z = -2.434, P = 0.015) than CT + laser group. There was significant difference on the volume of residual hemotoma among different timepoints in 2 groups (F = 528.850, P = 0.000), while there was no significant difference on the volume of residual hemotoma between 2 groups (F = 0.000, P = 0.991). The proportion of patients in Locator group with excellent treatment effect (defined as percentage of residual hemotma in initial hematoma volume before extubation ≤ 15% ) was significantly higher than that in CT + laser group (Z = -3.660, P = 0.000). There were no significant differences on the occurence rate of enlarged hematoma (adjusted χ² = 0.186, P = 0.666) and intracranial infection (adjusted χ² = 0.518, P = 0.472) between 2 groups. Conclusions The disposable stereotaxic locator is simple to operate, and helps to improve the therapeutic effect of hematoma puncture and catheter drainage with much better accuracy of catheter placement, higher efficacy of drainage of hematoma and less incidence of complications.

DOI: 10.3969/j.issn.1672-6731.2018.11.006