不同术式治疗高血压基底节区脑出血的临床疗效分析  

Comparison of curative effects of different operation modes for treating hypertensive basal ganglia hemorrhage

作　　者：贾增强[1] 范得普[1] 曾现伟[2] 

机构地区：[1]潍坊医学院,山东潍坊261031 [2]潍坊医学院附属医院神经外科,山东潍坊261031

出　　处：《现代医药卫生》2013年第8期1126-1128,共3页Journal of Modern Medicine & Health

摘　　要：目的探讨显微镜下小骨窗开颅血肿清除术和微创颅内血肿硬通道穿刺术治疗高血压基底节区脑出血的效果及预后,以期更好地指导临床救治。方法选择高血压基底节区脑出血患者209例为研究对象,其中开颅血肿清除术70例(开颅组),穿刺引流术139例(穿刺组)。采用SPSS19.0统计软件分析两组患者年龄、性别、血肿侧别及术前血肿量、术中出血量、术后残余血肿量、手术时间、平均住院时间和术后6个月格拉斯哥预后评分(GOS)。结果两组患者年龄、性别、血肿侧别及术前血肿量比较,差异无统计学意义(P>0.05),穿刺组患者手术时间、术中出血量、术后残余血肿量及术后6个月GOS与开颅组比较,差异有统计学意义(P<0.05)。结论微创颅内血肿硬通道穿刺引流术在一定程度上明显优于显微镜下小骨窗开颅血肿清除术,值得临床推广应用。Objective To investigate the effects and prognosis of small bone window craniotomy evacuation of hematoma and hard tunnel minimally invasive perforation for treating hypertensive basal ganglia hemorrhage （HBGH） in order to better guide its clinical treatment. Methods 209 patients with HBGH were selected as the research subjects,including 70 cases of craniotomy evacuation of hematoma and 139 cases of minimally invasive puncture drainage. The clinical characteristics and results including age,gender,locations of hematoma,preoperative volume of hematoma,intraoperative bleeding volume,postoperative residual hematoma, operation time, average hospitalization duration and postoperative 6-month GOS scores in the two groups were analyzed by SPSS 19.0. Results There were no significant differences in age, gender, hematoma location, preoperative volumes of hematoma between the two group （P〉0.05）. Compared with the craniotomy group, the operation time, intraoperative blood loss, average hospitalization duration,postoperative residual hematoma volumeand postoperative 6-month GOS scores in the puncture group had statistical differences （P〈0.05）. Conclusion Minimally invasive hard tunnel puncture drainage is significantly superior to microscopic small bone window craniotomy evacuation of hematoma to some extent in the treatment of HBGH and deserves to be promoted in clinic.

关 键 词：颅内出血 高血压性 外科学 基底神经节疾病 外科学 血肿 外科学 显微外科手术 外科手术 微创性 穿刺术 引流术 颅骨切开术 

分 类 号：R743.34[医药卫生—神经病学与精神病学]