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作 者:孙红星[1] 闫忠军 韩繁龙[1] 曹宁[1] 张国来[1]
机构地区:[1]延安大学附属医院东关分院综合外科,陕西延安716000 [2]唐都医院神经外科,陕西西安710038
出 处:《现代生物医学进展》2017年第28期5497-5500,共4页Progress in Modern Biomedicine
摘 要:目的:观察和比较传统开颅手术、显微镜下微创手术治疗基底节区高血压脑出血的临床疗效及安全性。方法:选择2011年10月至2016年1月在我院进行手术治疗的基底节区高血压脑出血患者320例,根据手术方式分为两组,每组160例患者。A组患者接受传统开颅血肿清除术,B组患者接受显微镜下小骨窗血肿清除术,比较两组患者的手术情况、临床疗效、术后生活质量的变化和不良反应的发生情况。结果:B组患者手术时间、ICU时间以及住院时间均较A组显著缩短(P<0.05),术中失血量、CSS评分以及术后24 h的血肿量显著低于A组(P<0.05),术后1个月临床总有效率显著高于A组(P<0.05)。随访6个月期间,B组生活质量显著优于A组(P<0.05),术后肺部感染、再次出血的发生率均显著低于A组(P<0.05)。结论:显微镜下行小骨窗血肿清除术治疗基底节区高血压脑出血的临床疗效显著优于传统开颅血肿清除术,且创伤较小,可有效缩短手术时间,提高手术安全性。Objective: To explore and compare the curative effect and safety of traditional craniotomy and minimally invasive surgery with microscope for patients with hypertensive basal ganglia hemorrhage. Methods: 320 patients with hypertensive basal ganglia hemorrhage were enrolled in our hospital from October 2011 to January 2016 and divided into two groups according to the operation type. Group A (n=160) accepted traditional craniotomy hematoma evacuation, and Group B (n=160) adopted small skull window hematoma evacuation under microscope, the operative conditions, clinical effect and postoperative quality of life and adverse reactions were compared between two groups. Results: The operation time, ICU stay and hospital stay of Group B were significantly shorter than those of the Group A (P〈0.05), the operative blood loss, CSS and postoperative 24 h hematoma volurne were lower than those of the Group A (P〈0.05). At 1 month after operation, the total clinical effective of Group B was superior to Group A (P〈0.05). As the ADL showing, the quality of life in the period of 6 month following-up in Group B were significantly better than those of Group A (P〈0.05). The incidence of pulmonary infection and bleeding again were lower than those of the Group A (P〈0.05). Conclusions: Small skull window hematoma evacuation under microscope was superior to traditional craniotomy hematoma evacuation for patients with hypertensive basal ganglia hemorrhage, which not only shortened the operative time, but also decreased the incidence of postoperative adverse reactions and increased the safety of operation.
关 键 词:显微镜 小骨窗血肿清除术 基底节区高血压脑出血 疗效
分 类 号:R743.34[医药卫生—神经病学与精神病学]
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