血肿清除术后早期联合高压氧治疗基底节区脑出血疗效观察  

Efficacy of early hyperbaric oxygen in treatment of basal ganglia hemorrhage after minimally invasive hematoma drainage

作　　者：洪良春[1] 吉健勇[1] 

机构地区：[1]解放军187医院神经外科,海口571159

出　　处：《西南国防医药》2016年第8期847-849,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨基底节区脑出血患者采用微创血肿清除术后早期联合高压氧治疗的疗效。方法选取2014年10月～2015年10月诊治的94例基底节区脑出血患者，随机分为对照组和观察组，对照组采用微创血肿清除术治疗，观察组在对照组基础上．术后3h联合高压氧治疗，比较两组治疗后相关评价指标及疗效。结果两组治疗前GCS、NDF、Barthel指数差异无统计学意义（P〉0．05）；治疗后，两组GCS评分和Barthel指数均显著升高（P〈0．05），而NDF评分显著降低（P〈0．05），但是观察组的改善幅度均大于对照组（P〈0．05）；两组重残、植物生存率差异不显著（P〉0．05），而观察组恢复良好率和中残率显著高于对照组（P〈0．05），病死率显著低于对照组（P〈0．05）；观察组并发症发生率也低于对照组（P〈0．05）。结论与常规微创血肿清除术相比，微创血肿清除术后早期联合高压氧治疗高血压脑出血的效果理想，更有利于患者神经功能的恢复，降低死亡率和并发症发生率，值得推广应用。Objective To explore the efficacy of early hyperbaric oxygen in the treatment of basal ganglia hemorrhage after minimally invasive hematoma drainage. Methods A total of 94 patients with basal ganglia hemorrhage admitted to our hospital from October 2014 to October 2015 were selected and randomly divided into a control group and an observation group. The control group was treated with minimally invasive hematoma drainage; the observation group was treated with hyperbaric oxygen three hours after the minimally invasive hematoma drainage. The relevant evaluation indexes and efficacy after the treatment were compared, Results The difference of the GCS, NDF and Barthel between the two groups before the treatment had no statistical significance （P 〉 0.05）; after the treatment, the GCS score and Barthel index in the two groups increased greatly （P 〈 0.05）, while NDF score decreased significantly （P 〈 0.05）, with the improvement in the observation group greater than that in the control group （P 〈 0.05）; there was no significant difference of the rates of severe disability and vegetative state between the two groups （P 〉 0.05）; the rates of excellent recovery and moderate disability in the observation group were much higher than those in the control group（P 〈 0.05）; the death rate was also significantly lower than that in the control group （P 〈 0.05）; the incidence of complications in the observation group was also lower than that in the control group （P 〈 0.05）. Conclusion Compared with conventional minimally invasive hematoma drainage, the treatment of basal ganglia hemorrhage with hyperbaric oxygen after minimally invasive hematoma drainage shows ideal effect, is more beneficial to the recovery of neural function in patients and reduction of death rate and the incidence of complications, and is worth popularization and application.

关 键 词：高血压脑出血 高压氧 微创血肿清除术 钻颅引流 

分 类 号：R743.34[医药卫生—神经病学与精神病学]