微创血肿清除术治疗脑出血患者近期生存率及颅外并发症研究  

Comparation of the short-term survival rate and the extracranial complications of patients with basal ganglia hemorrhage in stereotactic aspiration and thrombolysis group and those in conservative treatment group

作　　者：张微 胡伟[2] 曾文高[2] 唐荣华[2] 唐洲平[2] 雷霆[2] 

机构地区：[1]湖北宜昌市中医院神经科,443000 [2]华山科技大学同济医学院临床神经研究中心

出　　处：《中华实验外科杂志》2009年第9期1210-1211,共2页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金资助项目（30570628、30770751）

摘　　要：目的观察微创血肿清除术（微创术）对基底节脑出血患者近期生存率及颅外并发症的影响。方法我院2005～2007年收治的符合纳入标准的基底节出血量在35—50ml的脑出血患者118例，其中的微创血肿清除术治疗患者58例，保守治疗患者60例。对两组患者1个月内的生存率及并发症进行对照研究。结果58例微创术治疗患者存活57例，出现重度肺部感染3例，泌尿系感染2例，消化道出血2例，顽固性低钠血症4例，脑心综合征3例；60例保守治疗患者存活52例，出现重度肺部感染11例，泌尿系感染10例，消化道出血11例，顽固性低钠血症13例，脑心综合征11例。对两组患者1月内生存率及并发症进行统计学分析显示：微创术组生存率优于保守组（P〈0．05）；两组患者肺部感染，泌尿系感染，消化道出血，顽固性低钠血症，脑心综合征发生率差异有统计学意义（P〈0．05）。结论微创术治疗基底节脑出血手术简单，创伤小，术后并发症少、生存率较高。Objective To investigate the impact of stereotactic aspiration and thrombolysis on short-term survival rate and the extracranial complications in patients with basal ganglia hemorrhage. Methods The data of 118 cases with basal ganglia hemorrhage hospitalized in the department of neurology,Tongji Hospital,Tongji Medical College, Huazhong University of Science and Technolog from 2005 to 2007 （ the volume of hemorrhage 35-50 ml） who were in accordance with the inclusion criteria were analyzed retrospectively. 58 cases accepted the sterotactic aspiration and thrombolysis and 60 cases accepted conservative therapy. We analyzed the one-month survival rate and the complications. Results Among the sterotactic aspiration and thrombolysis group, 57 cases survived, 3 cases suffered severe lung infection, 2 cases were accompanied by urinary infection ,2 cases underwent gastrointestinal bleeding,4 cases suffered obstinate hyponatremia and 3 suffered cerebrocardiac syndrome. 52/60 of the conservative group survived, complications included 11 cases of severe lung infection, 10 cases of urinary infection, 11 cases of gastrointestinal bleeding, 13 cases of obstinate hyponatremia,and 11 cases of cerebrocardiac syndrome. The statistic analysis showed that the 1-month survival rate of the sterotactic aspiration and thrombolysis group was higher than that of the conservative group （ P 〈 0.05 ）. Incidence of lung infection, urinary infection, gastrointestinal bleeding, obstinate hyponatremia and cerebrocardiac syndrome of the two groups were statistically significant （P 〈 0.05 ）. Conclusion Sterotactie aspiration and thrombolysis is a simple and better operation method ,with little trauma, higher short-term survival rate and less complication.

关 键 词：微创血肿清除术 基底节脑出血 生存率 并发症 

分 类 号：R651.1[医药卫生—外科学]