两种手术方式治疗30～50ml基底节区高血压脑出血的疗效比较  

Contrast the Treatment Effect of Two Kinds of Operation Method Deal 30 to 50ml Hypertensive Basal Ganglia Hemorrhage

作　　者：李志强[1] 夏吉勇[1] 路长宇[1] 苗林[1] 郭吉卫[1] 

机构地区：[1]北京市门头沟区医院神经外科,102300

出　　处：《医学理论与实践》2016年第5期572-574,共3页The Journal of Medical Theory and Practice

摘　　要：目的：比较软通道穿刺引流术与小骨窗血肿清除术治疗中小量（30~50ml）高血压基底节区脑出血疗效,寻求治疗中小量脑出血更合理更有效的治疗方式。方法：选取2011年8月-2014年8月我院收治的78例30~50ml高血压基底节区脑出血患者,将其随机分为小骨窗血肿清除治疗组和软通道穿刺治疗组,各39例。观察两组的术后并发症、再出血发生率、死亡率、住院时间、治疗费用以及3个月后的ADL分级状况。结果：软通道穿刺组术后感染、癫痫、脑梗死等并发症的发生率低于小骨窗血肿清除组（P〈0.05）;两组间死亡率、再出血发生率差异无统计学意义（P〉0.05）;软通道组和小骨窗组恢复良好率分别为74.36%（29/39）和69.23%（27/39）,差异无统计学意义（P〉0.05）。软通道治疗组平均住院时间及平均住院费用均小于小骨窗组,差异有统计学意义（P〈0.05）。结论：对于中小量高血压基底节区脑出血,软通道穿刺引流术与小骨窗血肿清除术相比治疗效果相似,费用较低,住院时间短,并发症较少。Objective：Comparing two kinds of surgical treatment of small to moderate volume（30~50ml）hypertensive basal ganglia hemorrhage curative effect,seek treatment in small cerebral hemorrhage more reasonable and more effective treatments.Methods：Selected 78 cases of hypertensive basal ganglia hemorrhage patients whose cadaverine quantity of bleeding in our hospital from August 2011 to August 2014,and randomly divided into minimally invasive soft-channel treatment group（39cases）and a small bone window hematoma treatment group（39cases）.Two groups of the postoperative complications,the incidence of recurrent postoperative hemorrhage,the mortality rate,length of hospital stay,treatment cost,the overall efficiency of the treatment,and ADL classification status after three months were observed.Results：The minimally invasive soft-channel treatment group was significantly lower than the small bone window hematoma treatment group in postoperative morbidity such as postoperative infection,epilepsy,cerebral infarction（P0.05）;mortality rates and the incidence of bleeding again between the two groups there was no statistically significant difference（P0.05）;the recovery rate of the soft-channel group and the small bone window group were 74.35%（29/39）and 69.23%（27/39）,there was no statistically significant difference（P0.05）between the two groups.Conclusion：For small to moderate volume（30~50ml）hypertensive basal ganglia hemorrhage,the minimally invasive softchannel treatment has the similar therapeutic effect,lower cost,shorter hospitalization time,fewer complications compared with the small bone window hematoma treatment.

关 键 词：高血压脑出血 软通道穿刺 小骨窗开颅 

分 类 号：R743.34[医药卫生—神经病学与精神病学]