超早期小骨窗血肿清除术与延期开颅血肿清除术治疗重症高血压脑出血的比较研究  

Effect of early small bone window hematoma evacuation and delayed hematoma evacuation on treating severe hypertensive hemorrhage

作　　者：刘道斌[1] 魏建功[1] 宋同均[1] 王世强[1] 董世节[1] 黄汉文[1] 张琦辉[1] 黎志迪[1] 

机构地区：[1]广州医科大学附属深圳沙井医院神经外科,深圳518104

出　　处：《中国实用神经疾病杂志》2014年第10期15-16,共2页Chinese Journal of Practical Nervous Diseases

摘　　要：目的研究超早期小骨窗血肿清除术与延期开颅血肿清除术治疗重症高血压脑出血患者的疗效。方法将2010-01—2012-12我院收治的高血压脑出血患者纳入研究对象,随机分为分为给予超早期小骨窗血肿清除术治疗的观察组(45例)和给予延期开颅血肿清除术治疗的对照组(45例),观察手术相关指标、远期神经功能。结果观察组患者手术时间(95.8±11.4)min、术中出血量(135.8±21.3)mL、术后引流量(39.8±1.8)mL、下床活动时间(7.9±1.3)d、住院总时间(13.5±2.3)d、术后3个月、半年以及1a时观察组CSS评分(21.4±2.3、17.9±1.8、13.4±1.5)、NIHSS评分(25.7±3.6、22.2±2.3、19.3±1.9)均明显低于对照组(P<0.05)。结论超早期小骨窗血肿清除术有助于减小手术创伤,改善神经功能,在重症高血压脑出血的治疗中具有积极价值。Objective To study the effect of early small bone window hematoma evacuation and delayed hematoma evacuation on severe hypertensive hemorrhage. Methods patients with severe hypertensive hemorrhage in our hospital from January 2010 - December 2012 were enrolled and randomly divided observation group given early small bone window hematoma evacuation and control group given delayed hematoma evacuation. Then related indices with operation and nerve function were observed.Results In the observation group ,operation time（95.8 ± 11.4）min ,intraoperative bleeding volume（135.8 ± 21.3）ml , postoperative drainage volume（39.8 ± 1.8）ml ,ambulation time（7.9 ± 1.3）d ,hospitalization time （13.5 ± 2.3）d ,3 ,6 months and one year after operation ,CSS score（21.4 ± 2.3、17.9 ± 1.8、13.4 ± 1.5） ,NIHSS score 25.7 ± 3.6、22.2 ± 2.3、19.3 ± 1.9） were Significantly lower than those of control group （P〈0.05）.Conclusion early small bone window hematoma evacuation has positive value in treating severe hypertensive hemorrhage for it can reduce operation trauma and improve nerve function.

关 键 词：高血压脑出血 小骨窗手术 血肿清除术 神经功能 

分 类 号：R743.34[医药卫生—神经病学与精神病学]