小骨窗开颅血肿清除术与穿刺外引流术治疗高血压基底节区脑出血的疗效比较  

Hypertensive striatocapsular haemorrhage:compare the prognosis and short term effect of two therapeutic approaches

作　　者：张晓峰[1] 零达尚[1] 张建国[1] 何伟[1] 

机构地区：[1]南方医科大学附属小榄医院神经外科,广东中山528415

出　　处：《中国医药导报》2012年第16期77-80,共4页China Medical Herald

基　　金：中山市医学科学技术研究基金项目(项目编号:22252281)

摘　　要：目的通过比较小骨窗开颅血肿清除术与穿刺外引流术治疗高血压基底节区脑出血的近期疗效及远期预后,探讨微创术治疗本病的治疗方案。方法收集134例高血压性基底节区脑出血住院患者的出血量、GCS评分和出血部位等临床资料,根据其治疗方案分为小骨窗开颅血肿清除术和穿刺外引流术,以第30天CSS评分为近期疗效,6个月GOS评分为预后指标。采用SPSS 10.0软件,分析不同出血量、GCS评分水平、不同出血部位的患者近期疗效和预后与治疗方案的关系。结果按出血部位分层,在外侧型和大量出血型中,两种治疗方式的近期疗效及预后差异有统计学意义,其他出血部位两种治疗方式差异无统计学意义,按病情分层,GCS评分6～8分和GCS评分9～12分两种治疗方式的近期疗效及预后差异有统计学意义,GCS评分13～15分,两种治疗方式近期疗效及预后差异无统计学意义;按出血量分层比较,出血量<50 mL,小骨窗开颅血肿清除术的近期疗效及预后均好于穿刺外引流术。出血量≥50 mL,近期疗效两种治疗方式无差异,但预后比较,小骨窗开颅血肿清除较血肿穿刺外引流术好。结论高血压性基底节区脑出血的治疗方式,小骨窗开颅血肿清除术较穿刺外引流术效果较好。Objective To explore the therapeutic approaches for patients with hypertensive ganglion hemorrhage via short-term effect and prognosis of the two treatment groups（hematoma removed craniotomy with small bone window and cranial drill bur hole drainage）.Methods Of the inpatients with hypertensive ganglionic hemorrhage,143 cases were enrolled into our studies and divided into two groups corresponding to their managements.For each case,general data and radiological results were documented,and clinical results were rated in light of the SSC and GOS score.The short-term effect and prognosis of inpatients with various levels of hemotoma volume,location and GCS score were analyzed with SPSS 10.0 soft-ware.Results Layered by site of hematoma,there was statistically significant difference in the prognosis and short-term effect between the two approaches with site of posterolateral type and lateral type.There was no statistically significant difference in the prognosis and short term effect with other types.layered by patient＇s condition,there was statistically significant difference in the prognosis and short term effect between the two approaches with 6～8 points and 9～12 points.There was no statistically significant difference in the prognosis and short term effect with GCS score 13～15 points other types.layered by volume of hematoma,There was statistically significant difference in the prognosis and short term effect between the two approaches with volume50 mL.There was no statistically significant difference in the short term effect with volume≥50 mL,but the prognosis of removed craniotomy with small bone window group was superior to that of the cranial drill bur hole drainage one.Conclusion Generally,the prognosis and short term effect of removed craniotomy with small bone window is superior to that of cranial drill bur hole drainage.

关 键 词：小骨窗开颅血肿清除术 穿刺外引流术 高血压脑出血 基底节内囊区出血 预后 

分 类 号：R651.11[医药卫生—外科学]