微创穿刺联合侧脑室外引流对高龄高血压性小脑出血合并脑积水的临床观察  

作　　者：莫士田 黄志宁 范学政[2] 

机构地区：[1]广西壮族自治区上思县人民医院神经外科,广西535500 [2]广西中医药大学附属瑞康医院神经外科,530011

出　　处：《当代医学》2015年第6期1-3,共3页Contemporary Medicine

基　　金：广西壮族自治区卫生厅课题(Z 2013245);广西中医药管理局中医药专项课题(GZPT 13-19)

摘　　要：目的探讨微创穿刺联合侧脑室外引流术用于治疗高龄高血压性小脑大量出血并急性梗阻性脑积水的临床效果。方法选取高龄高血压性小脑大量出血伴急性梗阻性脑积水患者62例,随机均分成联合组和对照组(n=31)。联合组给予YL-1型微创针穿刺小脑血肿联合双侧脑室外引流术,对照组仅单纯给予双侧脑室外引流术,对2组疗效、小脑血肿和脑室积血清除时间、并发症及死亡情况进行观察。结果联合组患者小脑血肿和脑室积血平均清除时间为(8.4±2.1)d,对照组患者小脑血肿和脑室积血平均清除时间为(15.3±2.5)d,差异有统计学意义(P<0.05);联合组临床有效率70.9%,明显高于对照组的32.2%,差异有统计学意义(P<0.05);联合组死亡率和并发交通性脑积水率低于对照组,但差异无统计学意义。结论采用微创穿刺联合侧脑室外引流术治疗高龄高血压性小脑大量出血并急性梗阻性脑积水,可明显缩短小脑血肿和脑室积血清除时间,降低脑疝发生、术后交通性脑积水发病率和死亡率,显著改善患者的预后。Objective To investigate the efficacy of minimally invasive combined lateral external drainage on treatment 31 cases elderly patients with hypertensive cerebellar heavy bleeding with acute obstructive hydrocephalus. Methods 62 cases of hypertensive cerebellar heavy bleeding with acute obstructive hydrocephalus patients were selected and randomly divided into two groups,31 cases in each group. Combined group was given YL-1 type minimally invasive needle combined lateral external drainage,and control group was given lateral external drainage. The efficacy, cerebellar hematoma and intraventricular hemorrhage clearing time, complication, and death situation of two groups were observed. Results Cerebellar hematoma and intraventricular hemorrhage clearing time of combined group was （8.4 ±2.1） d,which was significantly lower than control group （15.3±2.5） d,the difference was statistically significant （P〈0.05）; the clinical efficiency of combined group was 72.9%,which was significantly higher than control group 32.2%,the difference was statistically significant （P〈0.05）; mortality rate and concurrent communicating hydrocephalus rate of combined group were lower than control group,but the difference was not statistically significant. Conclusion Minimally invasive combined lateral external drainage can effectively treat elderly patients with hypertensive cerebellar heavy bleeding with acute obstructive hydrocephalus,can significantly shorten the cerebellar hematoma clearance time,reduce hernia,communicating hydrocephalus,and morbidity rate,and significant improve the prognosis.

关 键 词：YL-1型微创针穿刺 侧脑室外引流术 高血压性小脑大量出血 急性梗阻性脑积水 

分 类 号：R651.1[医药卫生—外科学]