开颅血肿清除联合脑室外引流治疗高血压脑出血破入脑室的临床疗效观察  

Effect of Craniotomy Hematoma Evacuation Combined with Extraventricular Drainage in the Treat-ment of Hy pertensive Cerebral Hemorrhage into Ventricle

作　　者：高一凯 袁越 殷长江 GAO Yi-kai;YUAN Yue;YIN Chang-jiang(Shancdong Provincial Third Hospital,Jinan Shandong,250031,China)

机构地区：[1]山东省立第三医院,山东济南250031 [2]山东第一医科大学第一附属医院,山东济南250014

出　　处：《医学临床研究》2020年第9期1326-1329,共4页Journal of Clinical Research

摘　　要：[目的]探讨开颅血肿清除联合脑室外引流治疗高血压脑出血破入脑室的临床疗效。[方法]回顾性分析2016年1月至2018年5月本院收治的100例高血压脑出血破入脑室恋者的临床资料,根据手术方法的不同将其分为观察组(行开颅血肿清除联合脑室外引流手术治疗)和对照组(行单纯脑室外引流手术治疗),每组各50例。比较两组患者手术前后不同时间点的格拉斯哥昏迷评分(GCS)、颅内压(ICP)水平。并比较手术前、手术后2周两组患者血清氨基末端脑钠肽前体(NT-proBNP)、高迁移率族蛋白1(HMGB-1)水平,应用改良Rankin量表问卷(MRS)评估两组预后情况并记录两组患者手术并发症发生情况。[结果]术后3d、7d,观察组患者GCS评分高于对照组.ICP水平低于对照组。差异均有统计学意义(P<0.05)。术后2周。观察组悲者血清NT-proBNP,HMGB-1水平均低于对照组,差异均有统计学意义(P<0.05)。术后3个月,观察组患者预后良好率为58.00%(29/50).高于对照组患者的38.00%(19/50),差异有统计学意义(χ^2=4.006,P=0.045<0.05)。观察组患者的并发症发生率为14.00%(7/50),低于对照组患者的22.00%(11/50).差异无统计学意义(χ^2=4.006,P=0.298>0.05)。[结论]高血压脑出血破入脑室的悲者采用开颅血肿清除联合脑室外引流治疗的效果优于单纯脑室外引流手术,有利于患者血脑屏障恢复。可较好地改善患者的预后。[Objective]To investigate the clinical efet of craniotomy hemacoma removal combined with extraventrie-ular drainage in the treatment of hypertensive intracerebral hemorrhage into ventricle.[Methods]A retrospective analysis was performed on 100 patients with hypertensive cerebral hemorrhage who underwent surgery in our hospital from Janu-ary 2016 to May 2018.Among them,50 patients in the observation group were treated with craniotomy hematoma evacu-ation and extraventricular drainage.while 50 patients in the control group were trcated with simple craniotomy hermatoma clearance only.Glasgow coma score(GCS)and intracranial pressure(ICP)were compared between the two groups at dif-ferent time points before and after surgery.The serum N-terminal pro-brain natriuretic peptide(NT-proBNP)and high mobility group box 1 protein(HMGB 1)levels of the two groups were analyzed before and 2 weeks after surgery.Prog-nosis and surgical complications were evaluated by the modified Rankin scale questionnaire(MRS)at 6 months postopera-tively.[Results]There were no significant differences in GCS scores and ICP measurements between the two groups before and 1 day after surgery(P>0.05).The GCS scores of the observntion group at 3 days and 7 days after surgery were higher than those of the control group,while the ICP values of the observation group were lower than those of the control group(P<0.05).There was no significant difference between the two groups in the determination of NT-proBNP and HMGB1 before operation(P>0.05).At 2 weeks anfter surgery.the levels of NT proBNP and HMGBI in the observa-tion group were lower than those in the control group(P<0.05).At 3 months after operation.the prognosis rate of the observation group was 58.00%(29/50).which was higher than that of group B(38.00%,19/50).The difference was statistically significant(χ^2=4.006.P=0.045<0.05).The complication rate in the observation group was 14.00%(7/50),which was lower than 22.00%(11/50)in the control group,however.the difference was not statistically signifi-can

关 键 词：高血压/并发症 脑出血/外科学 脑室 

分 类 号：R544.1[医药卫生—心血管疾病]