微创穿刺引流手术治疗阿司匹林相关脑出血的临床效果研究  

Research on Clinical Effect of Minimally Invasive Puncture and Drainage in Treatment of Aspirin Related Cerebral Hemorrhage

作　　者：刘相和 LIU Xiang-he(Department of Neurosurgery,Qihe People’s Hospital,Qihe,Shandong Province,251100 China)

机构地区：[1]齐河县人民医院神经外科,山东齐河251100

出　　处：《系统医学》2017年第22期68-70,共3页Systems Medicine

摘　　要：目的探讨微创穿刺引流手术治疗阿司匹林相关脑出血的临床效果。方法回顾性分析2015年6月—2017年6月该科收治的阿司匹林引起的相关幕上脑出血患者52例。在患者知情同意的前提下,采用随机分组的方式分组,其中微创手术组(G1)28例,开颅手术组(G2)24例。围手术期给予止血及常规对症治疗。比较G1组及G2组术后1周格拉斯哥意识障碍(GCS)评分及血肿体积变化,并统计患者术后并发症(包括再出血、感染等)、死亡率及6个月后的生存质量行格拉斯哥预后(GOS)评分。结果 G1及G2组术后1周患者平均GCS评分均明显升高,血肿体积明显减少,两组间差异无统计学意义(P>0.05);住院期间G1组发生再出血8例,G2组8例,差异无统计学意义(P>0.05);G1组颅内感染2例,G2组8例,差异有统计学意义(P<0.05);G1组死亡5例,G2组死亡11例,差异有统计学意义(P<0.05);6个月后GOS评分G1组良好13例,有效10例,无效5例;G2组良好5例,有效7例,无效12例;差异有统计学意义(P<0.05)。结论微创穿刺引流手术能显著改善部分阿司匹林相关脑出血患者的意识障碍,减少血肿体积,术后并发症少,死亡率低,并能明显改善患者的预后。Objective To study the clinical effect of minimally invasive puncture and drainage in treatment of aspirin related cerebral hemorrhage.Methods 52 cases of patients with aspirin related supratentorial intracerebral hemorrhage admitted and treated in our hospital from June 2015 to June 2017 were selected and randomly divided into two groups with the consent of patients,including the minimally invasive surgery group with 28 cases(G1)and craniotomy(G2)group with 24 cases,and the patients adopted the hemostasis and routine symptomatic treatment during the perioperative period,and the GCS and changes of hematoma volume changes at 1 week after surgery were compared between the two groups,and the postoperative complications(including the rebleeding and infection),morality,and survival quality after six months of patients were for statistics and GOS marking.Results The average GCS score of patients in 1 week after surgery obviously increased,and the hematoma volume obviously decreased,and between the two groups,the difference was not statsistically significant(P>0.05),and there were 8 cases with rebleeding in the G1 group and 8 cases in the G2 group during the length of stay,and the difference was not statistically significant(P>0.05),and there was 2 cases with intracranial infection in the G1 group and 8 cases in the G2 groiup,and the difference was statistically significant(P<0.05),and there were 5 cases death in the G1 group and 11 cases death in the G2 group,and the difference was statistically significant(P<0.05),after 6 months,in terms of GOS score,in the G1 group,13 cases were good,10 cases were effective and 5 cases were ineffective,in the G2 group,5 cases were good,7 cases were effective and 12 cases were ineffective,and the differences were statistically significant(P<0.05).Conclusion The minimally invasive puncture and drainage surgery can obviously improve the disorder of consciousness of some patients with aspirin related cerebral hemorrhage,reduce the hematoma volume with few postoperative complications and

关 键 词：微创穿刺引流手术 阿司匹林 脑出血 

分 类 号：R543[医药卫生—心血管疾病]