微创穿刺碎吸术治疗高血压脑出血颅内血肿120例的疗效观察与价值评价  

Clinical observation and value evaluation of minimally invasive puncture and aspiration in the treatment of 120 cases with hypertensive cerebral hemorrhage intracranial hematoma

作　　者：刘光晃 吴分浪 陈盛勇 关则俭 邵强 LIU Guanghuang;WU Fenlang;CHEN Shengyong;GUAN Zejian;SHAO Qiang(Department of Neurosurgery,Yangjiang People's Hospital of Guangdong Province,Yangjiang 529500,China)

机构地区：[1]广东省阳江市人民医院神经外科,广东阳江529500

出　　处：《中国医药科学》2018年第21期185-187,222,共4页China Medicine And Pharmacy

摘　　要：目的探讨分析微创穿刺碎吸术治疗高血压脑出血颅内血肿的临床效果。方法根据患者头颅CT按多田计算方式计算脑出血血肿量,选取2014年6月～2017年6月我院中有手术指征,除外合并脑疝必须行开颅手术的,愿意接受手术治疗的患者240例,随机将240例患者分为两组:实验组(微创穿刺碎吸术治疗)、对照组(开颅血肿清除术治疗),每组120例。观察脑出血颅内血肿患者的临床效果,针对其血肿清除率、格拉斯哥预后评分(GOS评分)、改良Rankin量表评分(mRS)、日常生活能力量表-巴氏指数(BI)、生存率、平均住院时间、再发生出血率进行比较。结果经治疗,实验组GOS评分、mRS、BI均优于对照组,且住院时间短,血肿清除率较对照组高,实验组仅有1例出现颅内继发性再出血,与对照组相比,差异有统计学意义(P <0.05)。结论微创穿刺碎吸术应用于高血压脑出血颅内血肿具有非常好的临床效果,其可以缩短患者的住院时间,有利于患者的治疗和康复。Objective To explore the clinical effect of minimally invasive puncture and aspiration in the treatment of hypertensive cerebral hemorrhage intracranial hematoma.Methods The amount of hematoma in cerebral hemorrhage was calculated by multi-field calculation according to patients'head CT.240patients who were willing to undergo surgery and had indications for surgery in our hospital from June2014to June2017were selected,except for those with cerebral hernia.The240patients were divided into two groups randomly,the experimental group(treated by minimally invasive puncture and aspiration)and the control group(treated by craniotomy hematoma evacuation),each group had120cases.The clinical efficacy was observed,hematoma clearance rate,Glasgow prognosis score(GOS score),modified Rankin scale score(mRS),activity of daily living scale-Barr's index(BI),survival rate,average length of stay,recurrence bleeding rate were compared.Results After treatment,the GOS score,mRS and BI of the experimental group were better than the control group,and the hospitalization time was shorter,the hematoma clearance rate was higher than the control group.There was only one case of secondary intracranial rebleeding in the experimental group,compared with the control group,the difference was statistically significant(P<0.05).Conclusion The application of minimally invasive puncture and aspiration in the treatment of hypertensive cerebral hemorrhage intracranial hematoma has a very good clinical effect.It can shorten the patient's hospitalization time and be beneficial to the treatment and rehabilitation of the patients.

关 键 词：脑出血 高血压脑出血颅内血肿 微创穿刺碎吸术 开颅血肿清除术 

分 类 号：R651.1[医药卫生—外科学]