颅内血肿微创穿刺粉碎清除术治疗高血压脑出血的临床研究  

The clinical study of the debridement of smashed intracranial hematoma by micro traumatic puncture using in hypertensive cerebral hemorrhage

作　　者：孙家国[1] 冉贞权 陈蔚[1] 

机构地区：[1]内江市第三人民医院神经内科,四川内江641000

出　　处：《四川医学》2011年第10期1581-1583,共3页Sichuan Medical Journal

摘　　要：目的通过比较颅内血肿微创穿刺粉碎清除术治疗高血压脑出血与传统保守治疗方法比较,评价该技术在临床的应用价值。方法将2000年12月～2010年11月所有大脑半球出血量>30ml、丘脑出血>10ml、原发性脑室出血及脑实质出血破入脑室的高血压脑出血患者共计239例,根据手术与否分成手术组和对照组。比较两组患者的病死率和存活患者的神经功能缺损评分。将两组患者按照出血量分成2个亚组,比较各亚组病死率和存活患者的神经功能缺损评分。结果手术组患者的总病死率为26.2%,对照组的病死率为54.9%,两组之间差异有统计学意义(P<0.01),存活患者的神经功能缺损评分手术组与保守组之间差异无统计学意义(P>0.05),考虑手术组存活了大量重症患者所致。出血量30～50ml患者两亚组间病死率及各阶段神经功能缺损评分手术组明显优于对照组,差异有统计学意义(P<0.01)。出血量>50ml患者的病死率手术组明显低于对照组(P<0.01),由于对照组存活患者过少,未做神经功能缺损评分比较。结论应用颅内血肿微创穿刺粉碎清除术治疗高血压脑出血可以降低患者的病死率,对远期神经功能恢复有确切疗效。Objective To test the clininical value of the debridement of smashed intracranial hematoma by micro traumatic puncture of hypertensive cerebral hemorrhage comparing with traditional therapy method.Methods The by 239 inpatients whose hemorrhage volume more than 30ml in brain hemishere,or more than 10ml in thalamencephalon,or ventricle hemorrhage,or hemorrhage broken into ventricle from November 2000 to December 2010 were divided to two groups,operation group and comparison group,according whether the patients accepted the operation treatment.Compare the change of the total death rate and the neuropathic deficit grade between the two groups.The two groups were divided to two sub-group separately according the hemorrhage volume.Compare the change of the total death rate and the neuropathic deficit grade between the four sub-groups.Results The total death rate of operation group is 26.2%,and the comparison group is 54.9%.They had distinctive statistics significance（P〈0.01）.Neuropathic deficit grades between the two groups alive patients had no distinctive statistics significance（P〈0.05）.The reason may be operation group have a lot of critical patients to be alive.The death rate and the neuropathic deficit grade of the patients whose volume of hamatoma 30～50ml have distinctive statistics significance（P〈0.01）.The operation sub-group were better than comparison sub-group.In the sub-group with hamatoma volume more than 50ml.The death rate of operate group was obviously lower than comparison group（P〈0.01）.We can＇t compare the neuropathic deficit grade between these two sub-group because there were too few patients were alive in the comparison sub-group.Conclusion Using the debridement of smashed intracranial hematoma by micro traumatic puncture to treat hypertensive cerebral hemorrhage can lower the inpatients＇death rate.It has reliable long-term curative effect in nerve fuction meliorated.

关 键 词：高血压脑出血 颅内血肿微创穿刺粉碎清除术 病死率 神经功能缺损 

分 类 号：R651.1[医药卫生—外科学]