不同手术方式治疗高血压脑出血疗效对照研究  

Clinical efficacy of different modes of operation in the treatment of hypertensive cerebral hemorrhage

作　　者：张党林[1] 邓纪学[1] 

机构地区：[1]江苏省南京市江宁医院神经外科,江苏南京211100

出　　处：《实用临床医药杂志》2012年第21期149-151,共3页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11220194)

摘　　要：目的探讨传统大骨瓣开颅血肿清除术、小骨窗开颅血肿清除术、血肿碎吸术治疗高血压脑出血的临床疗效。方法选择本院神经外科进行手术治疗的高血压脑出血患者98例,随机分为传统大骨瓣开颅术组(A组)32例,小骨窗开颅术组(B组)33例,血肿碎吸术组(C组)33例,分析比较各组的手术时间、手术出血量、住院时间、神经功能恢复情况、术后并发症等临床指标。结果与A组相比,B组和C组在手术时间、手术出血量、住院时间等显著降低,B组和C组在术后神经功能恢复情况显著提高,B组和C组患者治疗后在再出血、应激性溃疡、肺炎、死亡率方面显著低于A组。结论相比于传统的大骨瓣开颅血肿清除术,小骨窗开颅血肿清除术和血肿碎吸术治疗高血压脑出血具有住院时间短、出血创伤小、可降低患者术后再出血率和达到抢救患者生命和降低致残率的目的,临床疗效优良,值得在临床外科推广。Objective To explore the clinical efficacy of traditional big bone flap craniotomy evacuation of hematoma, craniotomy with small bone window craniotomy, hematoma aspiration in the treatment of hypertensive intracerebral hemorrhage. Methods Ninety - eight patients with hypertensive cerebral hemorrhage in the department of neurosurgery in our hospital were randomly divided into traditional large bone flap craniotomy group （group A, n = 32）, small bone window craniotomy group （group B, n = 33）, and hematoma aspiration group （group C, n = 33）. The in- dices of operation time, bleeding volume in operation, duration of hospitalization, the recovery of neurological function, postoperative complications in each group were comparatively analyzed. Re- sults Compared with group A, the operation time, bleeding volume in operation, length of stay of B group and C group decreased significantly. After treatment, the postoperative recovery of neuro- logical function of group B and group C improved significantly, and the recurrent hemorrhage, stress ulcer, pneumonia, mortality of group B and group C was lower than that in group A. Conclusion Compared with the traditional big bone flap craniotomy evacuation of hematoma, craniotomy with small bone window craniotomy and hematoma aspiration in the treatment of hypertensive cerebral hemorrhage possess short hospitalization time, bleeding trauma and reduce the postoperative rebleeding rate, rescue patients and reduce the morbidity. The clinical curative effects are good and worthy of clinical application.

关 键 词：大骨瓣开颅血肿清除术 小骨窗开颅血肿清除术 血肿碎吸术 高血压脑出血 

分 类 号：R743.2[医药卫生—神经病学与精神病学]