微创穿刺术治疗大量脑出血的临床效果研究  

Effect of Minimally Invasive Craniopuncture in the Treatment of Massive Intracerebral Hemorrhage

作　　者：赖智勇[1] 李光勤[1] 付敏[1] 黄浩然[1] 

机构地区：[1]重庆医科大学附属第一医院神经内科,重庆市400016

出　　处：《中国全科医学》2012年第9期996-998,共3页Chinese General Practice

摘　　要：目的探讨微创穿刺术治疗大量自发性脑出血的临床疗效。方法选取我科2008年1月—2010年12月住院的53例大量自发性脑出血患者,将其随机分为两组,治疗组23例采用微创穿刺术治疗,对照组30例采用内科保守治疗。治疗30 d后分析两组的疗效及并发症情况。结果手术组的病死率(34.78%)明显低于对照组(63.33%,P<0.05);两组中出血量≥80 ml或格拉斯哥昏迷评分(GCS)<9分的患者,死亡率100%。两组患者的有效率、存活者的Barthel指数(BI)评分及并发症发生率比较,差异无统计学意义(P>0.05)。结论微创穿刺术治疗可减少大量自发性脑出血患者的病死率,但对于出血量≥80 ml或GCS评分<9分的患者预后较差。Objective To observe the effect of minimally invasive craniopuncture in patients with massive spontaneous intracerebral hemorrhage. Methods 53 patients with massive spontaneous intracerebral hemorrhage admitted to our department from January 2008 to December 2010 were randomly divided into treatment group （ n = 23 ） that was given minimally invasive cra- niopuncture therapy and control group （n = 30） that was given conservative treatment. The efficacy and complications of the two groups were analyzed 30 days after treatment. Results The mortality in craniopuncture group was significantly lower （ 34.78% ） than that in control group （63.33%, P 〈0.05） ; the mortality of patients whose hematoma volume≥80 ml or GCS score 〈9 in both groups were 100%. There were no statistically significant differences between the two groups in effective rate, Barthel Inde- xes and complication rates （P 〉 0. 05 ） . Conclusion The minimally invasive craniopuncture can reduce mortality in patients with massive spontaneous intracerebral hemorrhage, but it has poor prognosis for those patients whose hemorrhage volume ≥80 ml or GCS score 〈 9.

关 键 词：脑出血 外科手术 微创性 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]