微创穿刺粉碎清除术治疗高血压脑出血的临床效果  

Clinical efficacy of mini-invasive surgery in treatment of hypertensive intracerebral hemorrhage

作　　者：姜国勇 唐洲平[2] 

机构地区：[1]浙江省衢州市中医医院神经外科,浙江衢州324002 [2]华中科技大学同济医学院附属同济医院神经内科,湖北武汉430030

出　　处：《中国现代医生》2013年第9期17-19,共3页China Modern Doctor

基　　金：国家自然科学基金(81171089)

摘　　要：目的探讨微创穿刺粉碎清除术治疗高血压脑出血的效果。方法回顾性分析2010年7月～2012年6月在我科进行治疗的高血压脑出血患者60例的临床资料，其中采用微创穿刺粉碎清除术治疗的患者共30例，采用传统开颅手术治疗的患者30例。比较两组手术前后神经功能缺损程度。结果随访3个月，两组ADL分级比较差异显著（P〈0．01）。轻型和中型的患者，微创组治疗后NIHSS评分低于开颅组（P〈0．05）。出血量〈40mL和4060mL的患者．微创组治疗后NIHSS评分显著低于开颅组（P〈0．05）。微创组的肺部感染率、消化道出血率低于开颅组。再出血率高于开颅组，但两组比较，差异无统计学意义（P〉0．05）。两组死亡率比较，没有显著性差异（P〉0．05）。微创组的手术时间显著短于开颅组，但是血肿清除率低于对照组，两组比较，均有统计学意义（P〈0．05）。结论微创穿刺粉碎清除术总体的疗效优于传统的开颅手术，但血肿清除率低于传统开颅手术。Objective To discuss clinical efficacy of mini invasive surgery in treatment of HICH. Methods Clinical data of 60 cases with HICH from July 2010 to June 2012 were retrospective analyed. 30 cases were treated by mini invasive surgery and 30 cases were treated by traditional craniotomy. NIHSS of two groups were compared. Results Following-up for 3 months, ADL of two groups had significant difference （P 〈 0.01）. NIHSS of light and moderate pa- tients in mini invasive group were lower than craniotomy group （P 〈 0.01）. NIHSS of 〈40 mL and 40-60 mL in mini invasive group were lower than craniotomy group （P 〈 0.01）, Lung infection, gastrointestinal bleeding rate, rehaemor- rhage ratio, mortality had no significant difference （P 〉 0.05）. Operating time of mini invasive group was shorter than craniotomy group, and hematoma clearance was lower than craniotomy group （P 〈 0.01）. Conclusion Mini invasive surgery clinical efficacy is better than traditional craniotomy. But hematoma clearance is lower than traditional craniotomy.

关 键 词：微创 穿刺 粉碎 高血压脑出血 

分 类 号：R651.1[医药卫生—外科学]