小骨窗开颅术和软通道置入术治疗高血压脑出血的临床效果观察  

作　　者：何瞻[1] 丁方[1] 戎建东[1] 杨施迪 

机构地区：[1]浙江省宁波市医疗中心李惠利医院,315040

出　　处：《浙江临床医学》2017年第3期414-415,418,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨小骨窗开颅术和软通道置入术治疗高血压脑出血的临床效果。方法高血压基底节脑出血患者90例，随机分为观察组和对照组，每组各45例。对照组小骨窗开颅术，观察组行软通道置入术，比较两组患者手术资料，术后并发症、病死率以及临床疗效。结果观察组手术时间、术中出血量、住院时间均优于对照组，差异有统计学意义（P〈0．05）。观察组术后肺部感染及消化道出血等并发症发生率低于对照组，差异有统计学意义（P〈0．05）。观察组术后再出血发生率高于对照组，差异有统计学意义（P〈0．05）。两组患者术后病死率比较差异无统计学意义（P〉0．05）。术后随访6个月，观察组治疗有效率为68．89％，对照组治疗有效率为64．44％，两组比较差异无统计学意义（P〉0．05）。结论与小骨窗开颅术比较，软通道置入术治疗高血压脑出血手术创伤小，术后并发症少，临床效果满意，但需注意术后再出血的发生。Objective To explore the clinical effect of patients with small bone window craniotomy and soft channel implantation in the treatment of hypertensive intracerebral hemorrhage. Methods From May 2014 to March 2015, 90 patients with hypertensive hemorrhage of basal ganglia region were randomly divided into observation group and control group, 45 in each group. Control group was treated by small bone window craniotomy, the observation group was treated by soft channel implantation.Clinical data, postoperative complications, mortality rate and clinical curative effect were compared between two groups. Results In the observation group, the operation time, amount of bleeding, hospitalization time were better than that in the control group, the difference was statistically significant （P〈0.05） . The incidence of postoperative pulmonary infection and gastrointestinal bleeding in the observation group was lower than that in the control group, the difference was statistically significant （ P〈0.05 ） . The incidence rate of postoperative hemorrhage in the observation group was higher than that in the control group, the difference was statistically significant （ P〈0.05 ） . There was no significant difference in mortality rate between the two groups, and the difference was not statistically significant （ P〉0.05 ） . After 6-month follow up, The effective rate of observation group was 68.89%, the control group treatment effective rate was 64.44%. There was no significant difference in the treatment effective rate between the two groups, and the difference was not statistically significant （ P〉0.05 ） .Conclusion Compared with small bone window craniotomy in the treatment of hypertensive intracerebral hemorrhage, soft channel implantation is a kind of method with less invasive and postoperative complications, the treatment effect is favorable, but attention should be payed to the postoperative rebleeding.

关 键 词：小骨窗开颅术 软通道置入术 高血压脑出血 临床疗效 

分 类 号：R743.34[医药卫生—神经病学与精神病学]