开颅手术与锥颅抽吸治疗脑出血的临床效果对比  

Comparison of clinical therapeutic effects of craniotomy operation and cone skull suction therapy in treatment of cerebral hemorrhage

作　　者：孙卫[1] 习斌[1] 刘健民[1] 

机构地区：[1]江西省人民医院神经外科,南昌330006

出　　处：《中国当代医药》2016年第22期46-48,66,共4页China Modern Medicine

摘　　要：目的探讨开颅手术与锥颅抽吸治疗脑出血的临床效果。方法将2013年12月～2015年10月于我院确诊为脑出血并行手术治疗的81例患者纳入研究并随机分组，对照组40例患者行传统小骨窗开颅血肿清除术．治疗组41例患者则采用锥颅穿刺抽吸引流血肿清除术治疗，术后3d复查头颅cT以观察出血灶吸收情况，比较两组临床疗效的差异。结果治疗后，患者格拉斯哥昏迷评分（GCS）均提高，但治疗组改善更显著，且术后24h的GCS评分属重度昏迷及死亡例数所占比例更少，差异有统计学意义（P〈0．05）；治疗组手术时间、住院时间及术后拔管时间均更短，差异有统计学意义（P〈0．05）；神经功能：患者治疗7d及14d后Baahel指数均升高，但治疗组改善更显著，且治疗14d后Baahel评分优良率更高，差异有统计学意义（P〈0．05）；两组患者血肿清除率比较，差异无统计学意义（P〉0．05）。结论脑出血开颅手术与锥颅抽吸均可获得较好疗效，但锥颅抽吸治疗方案创伤小，恢复快，值得推广。Objective To investigate the clinical effect of craniotomy operation and cone skull suction therapy in treat- ment of cerebral hemorrhage.Methods Altogether 81 cases of patients who were diagnosed as cerebral hemorrhage and underwent parallel surgical treatment in our hospital from December 2013 to October 2015 were enrolled in the study and randomly divided into two groups,with 40 patients in control group and 41 cases in treatment group.Patients in the control group was treated with traditional small bone window craniotomy hematoma removal,while patients in the treat- ment group accepted skull puncture aspiration and bloody swollen clearance therapy.Post-operative 3 d CT （computer- ized tomography） was performed to observe hemorrhage absorption and the clinical curative effects in two groups were compared.Results Although GCS in two groups were increased post-operatively,a more remarkable improvement as well as the proportion of less cases of severe coma and death according to GCS after postoperative 24 hours was seen in treatment group,with a significant difference （P〈0.05）.Additionally,shorter duration of surgery,length of hospitalization and post-operative extubation time in the treatment group also showed superiority over those in the control group,with a significant difference （P〈0.05）.As for nerve functions,an increase of Barthel index of patients in two groups after 7-day and 14-day treatment was found,especially for patients in treatment group,with a significant difference （P〈0.05）;ln addi- tion,treatment group had higher excellent and good rate in Barthel score,with a significant difference （P〈0.05）.The hematoma clearance rate in two groups showed no significant difference （P〉0.05）.Conclusion The craniotomy operation and cone skull suction therapy can obtain good curative effect in treatment of cerebral hemorrhage,among which the cone skull suction therapy is featured with less invasion and fast recovery and deserves wider popularization.

关 键 词：脑出血 开颅手术 锥颅抽吸 疗效 

分 类 号：R743.34[医药卫生—神经病学与精神病学]