不同外科术式治疗高血压脑出血的效果与安全性比较  

Comparison of the efficacy and safety of different surgical treatments for hypertensive intracerebral hemorrhage

作　　者：袁雪松[1] 卞晓星[1] 包卿 魏文锋[1] 金鹏[1] 刘平[1] YUAN Xuesong;BIAN Xiaoxing;BAO Qing;WEI Wenfeng;JIN Peng;LIU Ping(Department of Neurosurgery,Wujin Hospital Affiliated to Jiangsu University,Changzhou 213002,China)

机构地区：[1]江苏大学附属武进医院神经外科,江苏常州213002

出　　处：《中国现代医生》2018年第30期78-81,共4页China Modern Doctor

摘　　要：目的探讨不同外科术式治疗高血压脑出血的效果与安全性。方法选取2015年1月~2017年7月在我院住院治疗的高血压脑出血患者84例,根据手术术式的不同,采用随机数字法分为常规开颅组(52例)和微创组(32例),开颅组患者给予开颅血肿清除术,微创组患者给予软通道微创穿刺引流术,比较两组患者的术中相关指标(血肿清除率、手术时间及术中出血量)、临床治疗效果及术后并发症(颅内感染、肺部感染、水电解质平衡紊乱和颅内再出血)的发生率。结果与开颅组相比,微创组患者的手术时间显著缩短,术中出血量显著降低,差异具有统计学意义(P<0.05);微创组患者手术治疗的总有效率为93.75%,开颅组患者手术治疗的总有效率为76.92%,差异具有统计学意义(P<0.05);微创组患者术后并发症的总发生率为37.50%,开颅组患者术后并发症的总发生率为38.46%,两组相比,差异无统计学意义(P>0.05)。结论微创穿刺引流术治疗高血压脑出血患者的临床效果较好,但实际应用中仍应具体情况具体分析,选择最佳的术式。Objective To investigate the effect and safety of different surgical treatments for hypertensive intracerebralhemorrhage. Methods A total of 84 patients with hypertensive intracerebral hemorrhage who were hospitalized in ourhospital from January 2015 to July 2017 were enrolled. According to different surgical procedures, they were randomlydivided into conventional craniotomy group （52 cases） and minimally invasive group （32 cases）. Patients in the craniotomygroup were treated with craniotomy hematoma evacuation, and patients in the minimally invasive group were given soft-channel minimally invasive puncture drainage. The intraoperative related indexes（hematoma clearance rate, operationtime and intraoperative blood loss）, the incidence of clinical treatment and postoperative complications （intracranial infection, pulmonary infection, water-electrolyte balance disorder and intracranial rebleeding） were compared between thetwo groups. Results Compared with that of the craniotomy group, the operation time in the minimally invasive groupwas significantly shortened, and the intraoperative blood loss was significantly lower, and the difference was statisticallysignificant（P〈0.05）. The total effective rate of surgical treatment in the minimally invasive group was 93.75%, and the total effective rate of surgical treatment in the craniotomy group was 76.92%, and the difference was statistically significant（P〈0.05）. The total incidence of postoperative complications in the minimally invasive group was 37.50%. The totalincidence of postoperative complications in the craniotomy group was 38.46%. There was no significant difference between the two groups （ 〉0.05）. The clinical effect of minimally invasive puncture drainage in patients withhypertensive intracerebral hemorrhage is better, but the actual application should be analyzed in detail and the bestsurgical procedure should be selected.

关 键 词：开颅血肿清除术 微创穿刺引流术 高血压脑出血 安全性 

分 类 号：R651.1[医药卫生—外科学]