脑立体定向血肿穿刺抽吸术与开颅血肿清除治疗高血压脑出血临床疗效的对比研究  

Comparative study of clinical effects of stereotactic hematoma aspiration and craniotomy evacuation of hematoma for hypertensive cerebral hemorrhage

作　　者：周元鼓 黄光否 黄启稳 廖国俏 ZHOU Yuangu HUANG Guangfou HUANG Qiwen LIAO Guoqiao(Department of Neurosurgery, People＇ s Hospital of Wuxuan, Wuxuan 545900, Chin)

机构地区：[1]广西来宾市武宣县人民医院神经外科,武宣545900

出　　处：《右江医学》2017年第2期198-201,共4页Chinese Youjiang Medical Journal

摘　　要：目的对比分析脑立体定向血肿穿刺抽吸术与开颅血肿清除术治疗高血压脑出血(HICH)的临床疗效。方法选择2012年5月至2016年9月采用立体定向血肿穿刺抽吸术治疗的60例HICH患者作为立体定向组,另选同期开颅血肿清除术治疗的60例HICH患者作为开颅手术组,比较两组患者手术耗时、术中失血量、住院时间、并发症发生情况、GCS评分及ADL分级。结果立体定向组患者手术耗时、住院时间、术中失血量均较开颅手术组明显减少,术后3 d、术后1周时GCS评分明显高于开颅手术组,术后6个月时ADL分级明显优于开颅手术组,差异有统计学意义(P<0.05)。立体定向组并发症发生率为8.33%,明显低于开颅手术组的23.33%(P<0.05)。结论脑立体定向血肿穿刺抽吸术治疗高血压脑出血疗效确切、创伤小、并发症少。Objective To compare and analyze clinical effects of stereotactic hematoma aspiration and craniotomy evacuation of hematoma for hypertensive cerebral hemorrhage（HICH）.Methods 60 HICH patients who underwent stereotactic hematoma aspiration from May,2012 to September,2016 were selected as stereotactic group,60 HICH patients who underwent stereotactic hematoma during the same period were selected as craniotomy group.And then,operation time,intraoperative hemorrhage,hospital stays,complications,GCS scores and ADL grades were compared between the two groups.Results The operation time,the hospital stays and the intraoperative hemorrhage of the stereotactic group were significantly less than those of the craniotomy group,the GCS score of the stereotactic group was significant higher than that of the craniotomy group three days and one week after operation,and the ADL grade of the stereotactic group was significantly superior to that of the craniotomy group six months after operation,so difference was statistically significant（P〈0.05）.Incidence of complications of the stereotactic group was 8.33%,significantly lower than that （23.33%） of the craniotomy group（P〈0.05）.Conclusion Stereotactic hematoma aspiration has the characteristics of good efficacy,small injury and few complications in the treatment of hypertensive cerebral hemorrhage.

关 键 词：立体定向 血肿穿刺抽吸术 开颅手术 高血压脑出血 

分 类 号：R544.1[医药卫生—心血管疾病] R651.12[医药卫生—内科学]