锁孔显微镜下清除高血压脑出血的临床效果  

Clinical Effect on Clearing Hypertensive Cerebral Hemorrhage Under Keyhole Microscope

作　　者：梁才干 莫泉 覃华强[1] 阮响 李宝嘉 林子同 LIANG Caigan;MO Quan;QIN Huaqiang;RUAN Xiang;LI Baojia;LIN Zitong(Department of Neurosurgery,People's Hospital of Huaiji County,Zhaoqing 526400,China)

机构地区：[1]广东省怀集县人民医院神经外科,广东肇庆526400

出　　处：《中国医药指南》2021年第10期38-39,42,共3页Guide of China Medicine

摘　　要：目的探讨锁孔显微镜下清除高血压脑出血的临床效果。方法选取2017年3月至2019年3月在我院神经外科治疗的84例高血压脑出血患者,随机分为两组,每组42例。对照组采用传统开颅血肿清除术治疗,观察组使用锁孔显微镜下血肿清除术治疗,比较两组患者的血肿清除率、GOS评分优良率、并发症发生率及生活质量。结果观察组血肿彻底清除率、血肿清除≥90%率明显高于对照组,而血肿清除<70%率明显低于对照组(P<0.05);两组在血肿清除70%~89%的概率比较,差异无统计学意义(P>0.05);随访3~6个月,观察组GOS评分优良率明显高于对照组(P<0.05);观察组消化道出血、肺部感染、再次脑出血、泌尿系统感染、水电解质紊乱等并发症总发生率明显低于对照组(P<0.05);观察组治疗后的生理功能、情感职能、躯体疼痛、精神健康评分明显高于对照组(P<0.05)。结论锁孔显微镜下清除高血压脑出血的临床疗效显著,血肿清除率高,并发症发生率低,能有效改善患者的预后,提高其生活质量。Objective To investigate the clinical effect of keyhole microscope in clearing hypertensive cerebral hemorrhage.Methods From March 2017 to March 2019 in our hospital neurosurgery treatment of 84 patients with hypertensive cerebral hemorrhage were randomly divided into two groups,42 cases in each group.The control group with traditional craniotomy hematoma removal treatment,the observation group was used keyhole microscopic haematoma elimination treatment,compared two groups of patients with hematoma clearance,GOS score,complications and quality of life.Results The rate of hematoma thorough clearance and hematoma clearance≥90%in the observation group was significantly higher than that in the control group,while the rate of hematoma clearance<70%was significantly lower than that in the control group(P<0.05).There was no significant difference between the two groups in the rate of hematoma clearance between 70%and 89%(P>0.05).After 3-6 months'follow-up,the GOS score of the observation group was significantly higher than that of the control group(P<0.05).The incidence of gastrointestinal bleeding,pulmonary infection,recerebral hemorrhage,urinary tract infection,water and electrolyte disorder and other complications in the observation group was significantly lower than that in the control group(P<0.05).The scores of physiological function,emotional function,physical pain,and mental health of the observation group after treatment were significantly higher than those of the control group(P<0.05).Conclusion The removal of hypertensive intracerebral hemorrhage under keyhole microscope has significant clinical efficacy,high hematoma clearance rate,low incidence of complications,and can effectively improve prognosis and quality of life.

关 键 词：高血压脑出血 锁孔显微镜手术 血肿清除率 并发症 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]