小骨窗开颅与硬通道穿刺治疗高血压脑出血的对比  

Comparative study of two therapeutic approaches for moderate hypertensive intracerebral hemorrhage

作　　者：梁日初[1] 周敏[1] 廖勇仕[1] 王兵[1] 崔晟华[1] 段永红[1] 王云[1] 

机构地区：[1]南华大学附属第二医院神经外科,湖南衡阳421001

出　　处：《中国现代医学杂志》2015年第16期66-69,共4页China Journal of Modern Medicine

摘　　要：目的比较小骨窗开颅血肿清除术和硬通道血肿穿刺引流术两种术式治疗高血压基底节区脑出血的疗效，评价两种手术方式的效果及安全性。方法回顾性收集资料完整的120例中等量（30~60m1）高血压脑出血（HICH）患者的临床资料，其中小骨窗开颅组68例，硬通道血肿穿刺组52例，评价两组患者的术后并发症、再出血率、近期疗效（术后3d内意识恢复情况）和远期疗效（6个月时GOS评分）等。结果①术后再出血小骨窗开颅组2例（2／68），硬通道穿刺组8例（8／52），两者差异有统计学意义（P〈0．05）；②术后3d意识恢复情况小骨窗组优于硬通道穿刺组（P〈0．05）；③两者在术后并发症、远期疗效方面差异无统计学意义（P〉0．05），但颅内感染发生率硬通道组（5例）高于小骨窗组（0例）。结论小骨窗开颅血肿清除术再出血率低、近期疗效优于硬通道穿刺术，在治疗中等量高血压基底节区脑出血中有一定优势。[ Objective ] To retrospectively evaluate and compare the curative effect between key-hole approach and hard-channel minimally invasive operation in treating patients with hypertensive basal ganglia hemorrhage. [Methods] Clinical data of 120 patients with moderate hypertensive intracerebral hemorrhage （30-60 ml） was col- lected, and the cases were divided into two groups （A, B） for different types of operation： the key-hole approach （Group A, n = 68） and the hard-channel minimally invasive operation （Group B, n = 52）. The complication, re- bleeding, operation effect between two groups were compared by statistical analyses. [ Results ] ①The postoperative re-bleeding rate of group B （8/52） was higher than group A （2/68）, （P 〈 0.05）. ②Group A had better early restora- tion of consciousness than Group B （P 〈 0.05）. ③There was no statistically difference in the postoperative complica- tion and the long term effect between the two groups, while intracranial infection rate of Group B （5/52） was higher than Group A （0/68）. [ Conclusions ] The key-hole approach has a lower postoperative bleeding rate and a better early restoration of consciousness, and has some advantages in the treatment of moderate hypertensive basal ganglia hemorrhage.

关 键 词：小骨窗开颅血肿清除术 硬通道穿刺血肿引流术 高血压基底节区脑出血 回顾性研究 

分 类 号：R743.2[医药卫生—神经病学与精神病学]