颅内压监测下定向穿刺置管联合血肿外引流治疗高血压脑出血  

Clinic analysis of stereotactic cannulation under intracranial pressure monitoring combined with hematoma external drainage on HICH patients

作　　者：柳浩然 吴海权 辛续伟 徐利民 李湘军 黄吉昌 

机构地区：[1]公安边防部队总医院神经外科,广东深圳518029

出　　处：《中国实用神经疾病杂志》2017年第22期55-58,共4页Chinese Journal of Practical Nervous Diseases

基　　金：深圳罗湖区科技创新课题(编号:2012072)

摘　　要：目的探讨颅内压监测下定向穿刺置管联合血肿外引流术对高血压脑出血(HICH)疗效的影响。方法将2010-12—2016-01在我院治疗的HICH患者纳入研究范围,并依据手术方式的不同将其分为观察组(n=36)与对照组(n=36),观察组采用颅内压监测下定向穿刺置管联合血肿外引流术,对照组采用传统开颅血肿清除术,观察并比较2组患者治疗相关情况及治疗前后血肿的变化情况、神经功能缺损情况及日常生活能力。结果观察组重症监护室(ICU)护理时间、住院时间、住院费用少于对照组,差异有统计学意义(P<0.05);治疗前2组患者血肿量、血肿周围组织水肿量、格拉斯哥昏迷评分(Glasgow)、神经功能缺损评分(NIHSS)及功能独立性评分(FIM)对比无差异(P>0.05);治疗后,观察组患者血肿量、水肿量、Glasgow评分、NIHSS评分及FIM评分的改善程度均优于对照组,差异有统计学意义(P<0.05)。结论颅内压监测下定向穿刺置管联合血肿外引流术具有创伤小、安全性好、恢复快等特点,能显著改善HICH患者神经功能缺损情况,提高生存质量。Objective To investigate the clinic effect of stereotactic cannulation under intracranial pressure monitoring combined with hematoma external drainage on HICH patients. Methods HICH patients in our hospital from December 2010 to Janu ary 2016 were selected and divided into observation group （n = 36） and control group （n = 36）, observation group was given ster- eotactic cannulation under intracranial pressure monitoring, control group was given eraniotomy evacuation of hematoma, therapeutic situation, hematoma changes, neurologic impairment condition and ADL of the two groups were observed. Results ICU nursing time, hospital stays, hospitalization expenses of observation group were less than control group, the difference was statistic significant （P〈0.05） ;difference of hematoma volume, perihematoma edema volume,Glasgow, NIHSS, FIM of the two groups before treatment had no statistical significance （P〉0. 05）, after treatment, improvement of hematoma volume, perihematoma edema vol ume,Glasgow,NIHSS,FIM of observation group were better than control group, the difference was statistic significant （P 〈0.05）. Conclusion Stereotactic cannulation under intracranial pressure monitoring combined with hematoma external drainage has less injury, better safety, quicker recovery,it can improve neurologic impairment and life quality of HICH patients.

关 键 词：颅内压监测 定向穿刺置管 血肿外引流术 高血压脑出血 神经功能缺损 

分 类 号：R743.34[医药卫生—神经病学与精神病学]