微创治疗高血压脑出血的临床分析  

Clinical Analysis on Minimally Invasive Treatment in Patients with Hypertensive Cerebral Hemorrhage

作　　者：赵展[1] 殷利明[1] 卓礼霞[1] 钟德泉[1] 王文涛[1] 徐伟光[1] 张威[1] ZHAO Zhan;YIN Li-ming;ZHUO Li-xia;ZHONG De-quan;WANG Wen-tao;XU Wei-guang;ZHANG Wei(Department of Neurosurgery,The First Affiliated Hospital,Guangdong Pharmaceutical University,Guangzhou 510080,Guangdong,China)

机构地区：[1]广东药学院附属第一医院,广东广州510080

出　　处：《医学信息（医学与计算机应用）》2014年第14期266-267,共2页Medical Information

摘　　要：目的探讨比较钻孔引流术和小骨窗开颅治疗高血压脑出血的临床疗效。方法选取我院从2006年6月~2013年6月接受微创治疗的高血压脑出血患者152例,分为钻孔引流组(88例)以及小骨窗开颅组(64例),比较两组的手术时间,血肿清除率,手术后拔除引流管的时间,急性期神经功能改善情况,手术后并发症以及手术后3个月的日常生活能力(ADL)以及病死率。结果钻孔引流组的手术时间短于小骨窗开颅组(<0.05),小骨窗开颅组的血肿清除率高于钻孔引流组(<0.05),手术后拔除引流管的时间小骨窗开颅组短于钻孔引流组(<0.05),手术后钻孔引流组发生颅内再出血大于小骨窗开颅组(<0.05),小骨窗开颅组发生颅内积气大于钻孔引流组(<0.05),皆有统计学意义。而在手术后发生肺炎、电解质紊乱、消化道出血、颅内感染、急性肾损伤、泌尿系感染等并发症差异无统计学意义(>0.05)。在急性期神经功能改善情况以及两组患者手术后3个月ADL各个级别和死亡率的比较差异无统计学意义(>0.05)。结论钻孔引流术和小骨窗血肿清除术都是治疗高血压脑出血行之有效的微创治疗,各有利弊,可以综合多方面因素进行选择。Objective To discuss clinical ef ects between trepanation&drainage and smal bone window craniotomy group in treating hypertensive hemorrhage patients.Methods We reviewed 152 cases after Mini-wound treatment in hypertensive hemorrhage from June 2006 to June 2011.The cases were divided into minimally invasive trepanation and drainage and craniotomy group with small bone window craniotomy group.The operation time,hematoma clearance rate,drainage tube extraction time,acute neurological function improvement,postoperative complications and activity of daily living of 3 months after surgery were compared.Results Trepanation&drainage group have lower rates of operation time and Hematoma clearance rate but higher rates of drainage tube extraction time and Intracranial rehaemorrhagia than those of smal bone window craniotomy group(<0.05).No significantly dif erences were found in complications of Pneumonia,electrolyte disturbances,gastrointestinal bleeding,intracranial infection,acute kidney injury,urinary tract infection,acute neurological improvement,3 months'ADL after surgery and mortality rate.Conclusion Both trepanation&drainage and smal bone window craniotomy groups are ef ective minimal y invasive treatment in treating hypertensive hemorrhage patients.Many factors can be integrated to our choice of operation by comparing advantages and disadvantages respectively.

关 键 词：高血压脑出血 微创治疗 临床疗效 

分 类 号：R6[医药卫生—外科学]