微创穿刺术与去骨瓣减压术治疗高血压基底节区脑出血疗效及并发症对比分析  

Comparative analysis of the effect and the complications of mini-invasive puncture and decompressive craniectomy in treatment of hypertensive basal ganglia hemorrhage

作　　者：杨永红[1] 贺学龙[1] 

机构地区：[1]重庆医科大学附属永川医院神经内科,重庆402160

出　　处：《现代医药卫生》2015年第1期36-39,共4页Journal of Modern Medicine & Health

摘　　要：目的比较分析微创穿刺术与去骨瓣减压术治疗高血压基底节区脑出血疗效及并发症。方法选择该院2011年10月至2013年10月收治的基底节区脑出血患者120例,均为高血压患者,将其随机分成微创穿刺术组和去骨瓣减压术组各60例。比较分析两组患者住院时间、疗效及并发症发生情况。结果与术前比较,两组患者术后美国国立卫生研究院卒中量表(NIHSS)评分均降低,差异有统计学意义(P<0.01)。与去骨瓣减压术组比较,微创穿刺术组患者平均住院时间缩短,总有效率提高,病死率降低,差异均有统计学意义(P<0.05)。治疗3个月时,微创穿刺术组患者日常生活能力(ADL)达自理水平良好状态的比例高于去骨瓣减压术组,差异有统计学意义(P<0.05)。两组并发症发生情况比较,微创穿刺术组继发性癫痫发生率、再出血发生率低于去骨瓣减压术组,差异均有统计学意义(P<0.05);而肺部感染、肾衰竭、多器官功能衰竭、消化道出血、脑心综合征、水电解质紊乱等严重并发症发生率比较,差异均无统计学意义(P>0.05)。结论微创穿刺术治疗基底节区脑出血疗效优于去骨瓣减压术,加强对上述并发症的防治,可降低其病死率。Objective To compare and analyze the effect and the complications of mini-invasive puncture and decompressive craniectomy in treatment of hypertensive basal ganglia hemorrhage. Methods A total of 120 patients with basal ganglid hemorrhage of this hospital from October 2011 to October 2013 were randomly divided into the mini-invasive puncture group（60cases） and the decompressive craniectomy group（60 cases）. The effect and the complications of the two groups were compared and analyzed. Results Compared to pre-operation,the patients′ NIHSS socres of the two groups after the operation decreased,which had statistical significance in difference（P〈0.01）. Compared with the decompressive craniectomy group,it was shorter in average hospitalization time,higher in overall effectiveness,and lower in fatality rate for the patients in the mini-invasive puncture group（P〈0.05）. At the time of treatment for 3 months,the proportion of those the ADL self-care level reached good conditions in the mini-invasive puncture group was higher than that in the decompressive craniectomy group（P〈0.05）. Referred to complications,the occurrence of secondary epilepsy and recurrent postoperative hemorrhage in the mini-invasive puncture group was lower than that in the decompressive craniectomy group（P〈0.05）. There were no statistical significant difference in pulmonary infection,renal failure,multiple organ failure,upper gastrointest bleeding,cerebrocardiac syndrome,water-electrolyte disturbances（P〉0.05）. Conclusion The mini-invasive puncture treatment is superior than decompressive craniectomy in treatment of hypertensive basal gan-glia hemorrhage in clinic effect. It shall be available to reduce fatality rate by strengthening the prevention of complications.

关 键 词：高血压 脑出血 基底神经节疾病 穿刺术 外科手术 微创性 死亡原因 预后 去骨瓣减压术 

分 类 号：R743.34[医药卫生—神经病学与精神病学]