微创穿刺血肿清除术治疗高血压脑出血效果观察  

Effect Observation of Minimally Invasive Evacuation of Hematoma in Treatment of Hypertensive Intracerebral Hemorrhage Patients

作　　者：邓友寿[1] 

机构地区：[1]攀枝花学院附属医院神经外科,四川攀枝花617000

出　　处：《解放军医药杂志》2016年第10期81-84,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：四川省卫生厅科研课题资助(120278)

摘　　要：目的观察微创穿刺血肿清除术治疗高血压脑出血的临床效果。方法选择2008—2015年手术治疗的高血压脑出血139例,将采用微创穿刺血肿清除术的65例作为微创组,将采用传统骨瓣开颅手术治疗的74例作为对照组。观察两组血肿清除率及围术期指标、术后并发症发生情况、神经功能缺损程度(NIHSS)评分及日常生活活动能力恢复情况。结果微创组术中出血量少于对照组,手术时间、意识恢复时间、住院时间均短于对照组(P<0.05)。两组血肿清除率达到90%的比例比较差异无统计学意义(P>0.05)。术后两组NIHSS评分均低于术前(P<0.05)。术后6个月,两组日常生活活动能力恢复率比较差异无统计学意义(P>0.05)。微创组手术并发症发生率低于对照组(P<0.05)。结论微创穿刺血肿清除术治疗出血量<60 ml的高血压脑出血效果满意,具有创伤小,恢复快,术后并发症少的特点。Objective To observe clinical effect of minimally invasive evacuation of hematoma in treatment of hypertensive intracerebral hemorrhage（ HICH） patients. Methods A total of 139 HICH patients with operative therapy from 2008 to 2015 were divided into 65 patients treated with minimally invasive evacuation of hematoma（ minimally invasive group） and 74 patients with traditional bone flap craniotomy（ control group）. Hematoma clearance rate,perioperative indexes,incidence rate of postoperative complications,national institute of health stroke scale（ NIHSS） score and recovery of daily life activities ability were observed in two groups. Results Values of operative time,blood loss volume,consciousness recovery time and length of hospital stay were lower in minimally invasive group than those in control group（ P〈0. 05）,but there was no significant difference in rate of hematoma clearance reached to 90% between two groups（ P〉0. 05）. NIHSS scores were significantly lower after operation than those before operation in two groups（ P〈0. 05）. Recovery rate of daily life activities ability showed no statistical difference between two groups（ P〉0. 05）. Incidence rate of postoperative complications in minimally invasive group was significantly lower than that in control group（ P〈0. 05）. Conclusion Minimally invasive evacuation of hematoma in treatment of HICH patients with hemorrhage volume less than 60 ml has good effect,slight trauma,rapid recovery and less postoperative complications.

关 键 词：颅内出血 高血压性 颅骨切开术 外科手术 微创性 

分 类 号：R743.34[医药卫生—神经病学与精神病学]