两种手术方法治疗高血压基底节区血肿的疗效分析  

Therapeutic effect analysis of two operative ways for hypertensive basal ganglia hematoma

作　　者：车万民[1] 周杰[1] 宋利梅[1] 李凯[1] 董涛[1] 赵全华[1] 

机构地区：[1]中国中医科学院望京医院神经外科,北京100102

出　　处：《医学信息（手术学分册）》2008年第8期677-678,共2页Medical Information Operations Sciences Fascicule

基　　金：北京市科委重大研究课题(课题编号:D0905004040311)

摘　　要：目的探讨高血压基底节区血肿两种手术方法的疗效,寻求最佳治疗方法。方法总结以往手术治疗的高血压基底节区血肿,对比小骨窗经外侧裂显微外科(显微手术组:64例)和传统开颅手术(传统手术组:59例)患者的死亡率和生存质量,评价两种方法的治疗结果。结果两组死亡率分别为21.9%(14/64)和22.0%(13/59),P>0.05;随访六个月,两组患者恢复的GOS评分分别为:显微手术组,GOS恢复分级Ⅴ+Ⅳ、Ⅲ、Ⅱ、Ⅰ分别为22、25、3、14例;传统手术组,GOS恢复分级Ⅴ+Ⅳ、Ⅲ、Ⅱ、Ⅰ分别为13、31、2、13例;两组GOS评分比较Ⅰ、Ⅱ级无显著差别(P>0.05),而Ⅴ+Ⅳ、Ⅲ级则差别显著(P<0.05)。结论小骨窗经外侧裂治疗高血压基底节区血肿能够明显提高存活者的生存质量。Objective To explore the efficacy of two operative ways for hypertensive basal ganglia hematoma and seek the best method. Methods To summarize two operative ways for hypertensive basal ganglia hematoma, comparing the cases＇ mortality and survival quality under microsurgieal treatment via lateral fissure approach with small bone flap （64 cases） and traditional craniotomy （53 cases）, evaluating therapeutic effects of two ways. Results The mortality was 21.9% and 22.0% respectively （ P 〉 0.05 ）. Follow up assessment according to the Glasgow Outcome Scale （GOS） for 6 months revealed that there were 22 cases with grade Vand IV ,25 cases with grade Ⅲ ,3 cases with grade Ⅱ and 14 cases with grade I in the group of microsurgery. Meanwhile, there were 13 cases with grade V and IV,31 cases with grade Ⅲ,2 cases with grade Ⅱ and 13 cases with grade I in the group of traditional operation. The GOS didn＇ i have obvious difference in grade Ⅱ and I （P 〉 O. 05）. On the contrary, the GOS had obvious difference in grade V, IV and m （P 〈 o. 05 ）. Conclusions Mierosurgical treatment via lateral fissure approach with small bone flap for hypertensive basal ganglia hematoma can improve the survival quality of existents prominently.

关 键 词：高血压脑出血 基底节区血肿 手术治疗 生存质量 

分 类 号：R743.2[医药卫生—神经病学与精神病学]