小骨窗微创手术治疗高血压基底节脑出血的临床疗效  

Clinical Efficacy of Small Bone Window Minimally Invasive Surgery on Basal Ganglia Hemorrhage in Hypertension

作　　者：李亚捷[1] 王磊[1] 谷震[1] 陈昱云[1] 戴成国[1] LI Ya-jie;WANG Lei;GU Zhen;CHEN Yu-yun;DAI Cheng-guo(Department of Neurosurgery,The Second People＇s Hospital of Yunnan,Kunming,Yunnan,650021,China)

机构地区：[1]云南省第二人民医院神经外科,云南昆明650021

出　　处：《现代生物医学进展》2018年第14期2705-2708,2713,共5页Progress in Modern Biomedicine

基　　金：云南省自然科学基金项目(2011FB376)

摘　　要：目的:研究小骨窗微创手术治疗高血压基底节脑出血的临床疗效。方法:选取2015年9月至2016年8月云南省第二人民医院收治76例高血压脑出血患者,根据患者入院顺序分为观察组和对照组,每组38例。观察组接受小骨窗微创手术,对照组接受传统开颅手术。比较两组患者手术情况,神经功能情况,并发症。结果:观察组术中出血量、手术时间、平均住院时间显著少于对照组(P<0.05),两组患者血肿清除率、二次手术率比较无显著差异(P>0.05)。两组日常生活活动能力(ADL)分级比较差异具有统计学意义(P<0.05)。两组患者癫痫、颅内再出血、颅内感染比较无显著差异(P>0.05),观察组的肺部感染、消化道出血率低于对照组(P<0.05)。结论:高血压基底节脑出血患者应用小骨窗微创手术,能有效减少术中出血量,缩短手术时间、平均住院时间,血肿清除效果较好,能促进患者神经功能恢复,且颅内感染率较低。Objective： To study the clinical efficacy of small bone window minimally invasive surgery on basal ganglia hemorrhage in hypertension. Methods： A total of 76 patients with hypertensive intracerebral hemorrhage, who were admitted to the Second People＇s Hospital of Yunnan from September 2015 to August 2016,were selected and divided into observation group（n=38） and control group（n=38） according to the order of admission. The observation group was given small bone window minimally invasive surgery,while the control group, traditional craniotomy. The operation conditions, neurological function, complications were compared between the two groups. Results： The intraoperative blood loss, operation time and average hospitalization time in the observation group were significantly less than those in the control group（P〈0.05）. There were no significant differences in the rate of hematoma clearance and secondary operation rate between the two groups（P〈0.05）. There was significant difference in the activities of daily living（ADL） classification between the two groups（P〈0.05）. There were no significant differences in epilepsy, intracranial rebleeding and intracranial infection between the two groups（P〈0.05）. The rates of lung infection and digestive tract hemorrhage in the observation group were significantly lower than those in the control group（P〈0.05）. Conclusion： The use of small bone window minimally invasive surgery in the patients with basal ganglia hemorrhage can effectively reduce intraoperative blood loss, shorten the operation time and average hospitalization time, and hematoma removal effect is better, which can promote the recovery of neurological function, and the rate of intracranial infection is lower.

关 键 词：小骨窗微创手术 高血压 基底节脑出血 临床疗效 

分 类 号：R743.34[医药卫生—神经病学与精神病学]