不同麻醉方式小骨窗开颅治疗高血压脑出血的临床分析  

Clinical analysis of small bone window craniotomy in the treatment of hypertensive intracerebral hemorrhage under different anesthesia

作　　者：汤华[1] 李刚[1] 陈少军[1] 周建[1] 管玉华[1] 

机构地区：[1]湖北宜昌市第一人民医院神经外科,宜昌443000

出　　处：《中国实用神经疾病杂志》2014年第2期14-16,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的比较不同麻醉方式下施行小骨窗开颅显微手术治疗高血压脑出血的疗效,探讨其临床应用价值。方法回顾性分析2010-01-2013-01我科手术治疗的高血压脑出血并成功随访的患者296例,其中171例行局麻,125例行全麻。对比分析两组术后并发症发生率、近期GOS评分、半年后ADL分级等指标。结果局麻病例术后肺部感染率、应激性溃疡发生率、病死率低于全麻组,再次出血、脑积水发生率以及近期、远期病残率无明显差异。结论局麻下小骨窗手术治疗高血压脑出血,具有时间短、相对并发症少、节省住院费用等优点,值得临床推广。Objective To compare the curative effect of small bone window craniotomy in the treatment of hypertensive intracerebral hemorrhage in different anesthesia. Methods Clinical data of 296 patients suffering from high blood--brain hemor- rhage who were admitted to our hospital from January 2010 to January 2013 were investigated. They were treated with small bone window craniotomy under the different anesthesia and were divided into two groups： local anesthesia group （171 cases） and general anesthesia group （125 cases）. The difference in curative effect between the two groups was concluded. Results The incidence of postoperative pulmonary infection, stress ulcer incidence, mortality in local anesthesia group were lower than the general anesthesia group, there was no significant difference in re--bleeding, hydrocephalus and long--term morbidity be- tween two groups. Conclusion Small bone window craniotomy microsurgical in the treatment of hypertensive intracerebral hemorrhage under local anesthesia with fewer traumas, short time, and relatively few complications, save hospitalization costs, etc.

关 键 词：高血压脑出血 小骨窗 局部麻醉 全身麻醉 

分 类 号：R743.34[医药卫生—神经病学与精神病学]