关键词: 自发性脑出血, 微创, 头皮定位, 立体定向颅内血肿穿刺引流术

Abstract: Objective To explore the clinical efficacy of scalp-positioning combined with stereotactic puncture and external drainage in the treatment of cerebral hemorrhage in the basal ganglia. Methods From January 2023 to January 2025,the Department of NeuroSurgery of Jianhe County People's Hospital,Guizhou Province,performed preoperative CT reconstruction of the head and localization of scalp electrode films on 42 patients with spontaneous basal ganglia intracerebral hemorrhage.Based on the principle of spatial stereocoordinate orientation,the central position of the largest layer of intracerebral hematoma was taken as the target,and the frontal nodule was used as the main puncture point.The puncture path was located using the principle that the sagittal plane and the cross-section “intersect in a straight line”.The basal ganglia hematoma was punctured under the positioning correction of the scalp electrode patch,and relevant data were collected for evaluation. Results Among the 42 cases of basal ganglia intracerebral hemorrhage,26 cases had excellent puncture site localization,15 cases had moderate localization,and 1 case had poor localization.The average operation time was 42 minutes and the average intraoperative blood loss was 12.4ml.The neurological function was evaluated 24 hours after the operation.The limb muscle strength improved in 25 cases,remained unchanged in 14 cases,and worsened in 3 cases.The language function score improved in 14 cases,remained unchanged in 11 cases,and worsened in 2 cases.Three months after discharge,the Activities of daily Living (ADL) classification included 6 cases at grade I,17 cases at grade II,14 cases at grade III,and 4 cases at grade IV. Conclusion The scalp-positioning combined with stereotactic puncture and drainage has a good clinical effect in the treatment of cerebral hemorrhage in the basal ganglia region.It is a simple,practical and accurately positioned method,which is conducive to reducing the surgical difficulty and trauma,and is worthy of clinical promotion and application.

Key words: Spontaneous cerebral hemorrhage, Minimally invasive surgery, Scalp-positioning, Stereotactic puncture and drainage