微创软通道双管引流治疗大血肿量的高血压脑出血的临床探讨  

Clinical study of minimally invasive soft-channel double-tube drainage for treatment of massive hematoma with hypertensive intracerebral hemorrhage

作　　者：王维军[1] 周宁全[1] 吕廷勇[2] 唐其权 王超 刘凡 何贵龙 WANG Weijun;ZHOU Ningquan;LV Yanyong;TANG Qiquan;WANG Chao;LIU Fan;HE Guilong(Department of Neurosurgery,First Affiliated Hospital of Qiannan Medical College For Nationalities,Guizhou Province,Duyun 558000,China;Department of Radiology,First Affiliated Hospital of Qiannan Medical College For Nationalities,Guizhou Province,Duyun 558000,China)

机构地区：[1]贵州省黔南民族医学高等专科学校第一附属医院神经外科,贵州都匀558000 [2]贵州省黔南民族医学高等专科学校第一附属医院影像科,贵州都匀558000

出　　处：《中国医药科学》2018年第19期31-35,共5页China Medicine And Pharmacy

基　　金：贵州省黔南民族医学高等专科学校科研基金项目(QNYZ201729)

摘　　要：目的探讨微创手术双管引流治疗血肿量大于70mL的高血压脑出血的疗效。方法微创软通道手术治疗出血量大于70mL的高血压脑出血患者45例,按置管数量分为单管组和双管组,单管组27例,双管组18例,用两组患者的死亡率,两组中伴脑疝患者的死亡率,血肿平均排空时间,术后颅内感染的发生率,术后再出血的发生率,出院时GOS评分,平均住院日等临床资料进行统计学对比分析。结果单管组与双管组患者的年龄、性别和术前GCS评分差异无统计学意义(P> 0.05)。双管组的血肿量大于单管组(P <0.05),术后单管组与双管组的总死亡率、伴脑疝患者死亡率、术后再出血率、血肿平均排空时间、并发颅内感染的发生率、出院时功能恢复GOS评分以及平均住院日进行对比,差异均无统计学意义(P> 0.05)。结论微创软通道双管引流治疗血肿量大于70mL的HICH是安全、有效的,并且治疗效果优于单管引流,并没有增加术后再出血率和颅内感染率。Objective To investigate the efficacy of double-tube drainage in the treatment of hypertensive cereebral hemorrhage with hematuma volume greater than 70ml. Methods 45 patients with hypertensive intracerebral hemon＇hage whose hemon＇hage volume was more than 70 ml were treated by minimally invasive soft-channel operation. According to the number of catheters, they were divided into single-tube group and double-tube group, 27 cases in single-tube group and 18 eases in double-tube group. The mortality rate of patients in two groups was as follows： mortality rate of patients with cerebral hernia, average evacuation time of hematoma, incidence of intracranial infection after operation, and re-emergence after operation. The incidence of blood, the GOS score at discharge and the average length of slay were analyzed statistically. Results There was no significant difference in age, gender and preoperative GCS score between the single-tube group and the double-tube group （P 〉 0.05）. The amount of hematoma in the double-tube group was greater than that in the single-tube group （P 〈 0.05）. The total mortality of the singletube group and the double-tube group, the mortality rate of patients with cerebral palsy, the rate of postoperative rebleeding, the average emptying time of hematoma, and concurrent There was no significant difference in the incidence of intraeranial infeetion, GOS seore at diseharge, and mean hospitalization day （1- 〉 0.05）. Conclusion Minimally invasive soft-ehannel double-tube drainage for HICH with a hematoma volume greater than 70 ml is safe and effective, and the treatment effect is better than single-tube drainage, and does not increase the rate of postoperative rebleeding and intraeranial infection.

关 键 词：高血压脑出血 微创手术 单管引流 双管引流 预后 

分 类 号：R651.1[医药卫生—外科学]