不同手术方式治疗高血压脑出血的疗效对比观察  

A comparative study of different surgical treatment of hypertensive intracerebral hemorrhage

作　　者：唐小虎 刘家传[1] 张星 张永明[1] 黄振山[1] 温玉东 汤宏[1] TANG Xiaohu;LIU Jiachuan;ZHANG Xing;ZHANG Yongming;HUANG Zhenshan;EN Yudong;TANG Hong(Department of Neurosurgery,105 Hospital of PLA,Hefei,Anhui 230032,China)

机构地区：[1]安徽医科大学附属解放军临床学院中国人民解放军第一零五医院神经外科,安徽合肥230032

出　　处：《安徽医药》2018年第5期843-847,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨3种手术方式治疗高血压脑出血的优缺点,选择适宜的手术方法。方法回顾分析中国人民解放军第一零五医院2011年1月—2017年1月收治的215例高血压脑出血患者的临床资料,对比大骨瓣及小骨瓣开颅血肿清除术、神经导航辅助血肿抽吸术的手术指标、并发症发生、神经功能及预后情况。结果根据病情采取三种手术方式均取得满意效果,其中导航组手术时间(61.85±14.62)min及住院时间(17.30±4.09)d最短,术中失血量(89.78±14.37)m L最少,肺部感染发生率(26.09%)最低,预后最好。结论神经导航辅助血肿抽吸术及小骨瓣开颅术损伤小,恢复快,提高患者生存质量,不同手术方式各有适应证,遵循个体化原则选择最合理的手术方式。Objective To explore the advantages and disadvantages of three kinds of surgical treatment of hypertensive intracerebral hemorrhage,and to choose the appropriate surgical method.Methods The clinical data of 215 patients with hypertensive intracerebral hemorrhage who hospitalized in 105 Hospital of PLA from January 2011 to January 2017 were retrospectively analyzed,and the surgical indicators,complications,neurological function and prognosis of large bone flap craniotomy,small bone flap craniotomy and navigation-assisted hematoma aspiration surgery were compared.Results According to the condition,three kinds of surgical methods have achieved satisfactory results.The operation time(61.85±14.62)min and the length of hospital stay(17.30±4.09)d were the shortest in the navigation group,and the blood loss(89.78±14.37)mL was minimal during the operation.The incidence of pulmonary infection is the lowest(26.9%)and the prognosis is the best.Conclusions Nerve navigation assisted hematoma aspiration and small bone flap craniotomy injury have less injury,quicker recovery,better quality of life,but the different surgical methods have the different indications,the individual principle should be followed to choose the most reasonable way of operation.

关 键 词：高血压 脑出血 手术方式 

分 类 号：R651.12[医药卫生—外科学]