不同术式高血压脑出血疗效分析  

The analysis of the effects and indications of different surgical methods for hypertensive intracerebral hemorrhage

作　　者：廖昆[1,2] 杨恒[2] 岑武[3] 田景友[2] 吴金桥[2] 蒋伟峰[2] 王俊[2] 刘窗溪[2] 

机构地区：[1]贵州省兴义市人民医院神经外科,兴义市562400 [2]贵州省人民医院神经外科 [3]遵义医学院

出　　处：《立体定向和功能性神经外科杂志》2013年第3期168-171,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的探讨不同术式治疗高血压脑出血的效果,为合理选择术式提高疗效提供依据。方法回顾性分析2009年1月～2012年4月我院收治的171例高血压脑出血患者的临床资料,比较采用大骨瓣开颅血肿清除术、小骨窗显微血肿清除术、钻孔血肿抽吸引流术、脑室镜血肿清除术治疗2个月后各组患者GCS评分结果,术后6个月随访ADL评分。结果各组患者术后2个月GCS评分相比手术前均显著改善,差异具有统计学意义(P<0.01)。手术后随访6个月,开颅血肿清除组患者ADL评分1～2级者26例(44.8%),小骨窗显微血肿清除术组患者ADL评分1～2级者25例(59.5%),钻孔血肿引流组患者ADL评分1～2级者31例(67.4),脑室镜血肿清除术组患者ADL评分1～2级者16例(64.0%),均获满意疗效。结论术前全面、准确评估高血压脑出血的类型,根据患者病情、年龄、发病时间选择合理的手术方式治疗,可显著提高疗效,有利于降低后遗症。Objective To observe the effects and indications of different surgical methods of hypertensive intracerebral hemorrhage.Methods The clinical materials of 171patients with hypertensive intracerebral hemorrhage from Jan 2009to Apr 2012in our hospital were retrospectively analysed and the immediate and long-term effects of the following different surgical approaches including decompressive cran iectomy,small bone window,burr holes draw and assistant-endoscopy for hematoma evacuation.Results GCS score of each group for two months of post-operation was higher than that of pre-operation（P0.01）.The follow-up study of six months suggest that curative effect in each group was satisfactory.Conclusion The selection of reasonable operation methods according to age,condition,hemotama types and course could improve the curative effect of surgical methods for the patients with forward functional recovery.

关 键 词：高血压脑出血 手术方式 疗效 

分 类 号：R743.34[医药卫生—神经病学与精神病学]