软-硬通道结合技术穿刺介入治疗高血压脑出血临床分析  

Clinical study on application of soft- hard puncture channel bonding technique for interventional treatment of hypertensive intracerebral hemorrhage

作　　者：罗杰[1] 黄明火 魏小川[1] 熊学辉[1] 

机构地区：[1]湖北省黄冈市中心医院神经外科,湖北黄冈438000

出　　处：《临床和实验医学杂志》2017年第1期68-71,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨联合应用软硬通道微创治疗在高压脑出血中的应用效果及手术方式,为今后该病手术治疗技术提高提供参考。方法收集2013~2015年6月期间住院治疗的高血压脑出血患者78例,纳入研究。其中40例接受软通道或硬通道微创穿刺归为对照组,38例联合应用软通道和硬通道微创穿刺的患者归为观察组。对比术后1 d、3 d、5 d、7 d两组患者血肿平均残存量、术后3周治疗总有效率、术后3个月患者日常生活质量(ADL)。结果手术后1d、3 d、5 d及术后7 d观察组血肿残存均明显减少且低于对照组(P均<0.0.5);观察组在术后3周治疗总有效率(68.42%)明显高于对照组(47.50%),病死率(23.68%)明显低于对照组(35.00%),差异均有显著性(P<0.05);术后3个月观察组患者结局普遍好于对照组,以ADL2~ADL3多见(57.89%),对照组为32.50%,差异有显著性(P<0.05);观察组病死率(15.80%)明显低于对照组(40.00%),差异有显著性(P<0.05)。结论软-硬通道结合应用在高血压脑出血微创穿刺介入治疗中,能加快血肿清除,提高疗效,降低病死率,促进患者近期生活质量改善,安全性高,值得应用。Objective To explore the efficacy of combination of hard and soft channel puncture for minimally invasive treatment of hypertensive cerebral hemorrhage and surgical procedures,in order to provide reference to improve the surgical procedures for treatment of this disease.Methods The clinical data of 78 patients with hypertensive cerebraal hemorrahge treated in this hospital during 2013 to June 2015 were retrospectively analyzed. Among them,40 cases received soft passage or hard channel minimally invasive puncture were classified as control group,and 38patients with combination of soft and hard channel minimally invasive puncture were classified as observation group. In comparing these two groups of patients at different times,the average residual amount of postoperative hematoma at 1 d,3 d,5 d and 7 d after operation and the effective rate at 3 weeks after treatment and the quality of daily life of patients after 3 months（ ADL） were compared between these 2 groups. Results The residual volumes of hematoma in 1 d,3 d,5 d and 7 d after the surgery in patients of observation group were significantly reduced and the volume of remaining hematoma was lower than that of patients in control group（ allP〈0. 0. 5）. The total efficiency（ 68. 42%） of the treatment in patients of observation group after three weeks was better than that（ 47. 50%） of patients in control group,and the mortality of patients in observation group（ 23. 68%） was lower than that（ 35. 00%） of patients in control group（P〈0. 05）. The postoperative outcome observed in patients after3 months generally better than that of control group,and ADL2 ~ ADL3 were common in observation group（ 57. 89%）,and they were better than those of control group（ 32. 50%）（P〈0. 05）. The mortality rate in observation group was 15. 80% and it was lower than that（ 40. 00%） of control group（P〈0. 05）. Conclusion The combined application of hard and soft channels for invasive interventional therapy for hypertensive intracerebral he

关 键 词：高血压脑出血 硬通道 软通道 微创穿刺技术 

分 类 号：R651.1[医药卫生—外科学] R544.1[医药卫生—临床医学]