两种外科术式对脑室出血铸型的疗效及安全性影响  

Influence of two kinds of surgical methods on clinical efficacy and safety of patients with intraventricular hemorrhage casting

作　　者：何庆华 HE Qing-hua(Neurosurgery department,Nanping Second Hospital,Nanping 354200,China)

机构地区：[1]南平市第二医院神经外科,福建南平354200

出　　处：《吉林医学》2022年第11期3066-3068,共3页Jilin Medical Journal

摘　　要：目的:探讨脑室外血肿引流术和经额锁孔血肿清除术对脑室出血铸型疗效及安全性的影响。方法:回顾性分析南平市第二医院脑室出血铸型患者共142例临床资料,其中82例采用脑室外血肿引流术治疗(对照组),60例采用经额锁孔血肿清除术治疗(试验组),比较两组术中出血量、术后残余血肿量、住院时间、置管时间、出院时格拉斯哥预后量表(GOS评分)及术后不良事件发生情况。结果:试验组术中出血量、术后残余血肿量、住院时间及置管时间均显著少于对照组,差异有统计学意义(P<0.05);试验组出院时GOS评分显著高于对照组,差异有统计学意义(P<0.05);试验组术后死亡率和脑积水发生率均显著低于对照组,差异有统计学意义(P<0.05);两组术后再出血、脑梗死及癫痫发生率比较,差异无统计学意义(P>0.05)。结论:相较于脑室外血肿引流术,经额锁孔血肿清除术治疗脑室出血铸型可有效提高血肿清除效果,改善神经功能损伤,加快术后康复进程,并有助于降低术后死亡和脑积水发生风险。Objective To investigate the influence of extraventricular hematoma drainage and frontal keyhole hematoma clearance on clinical efficacy and safety of patients with intraventricular hemorrhage casting.Method Clinical data of 142 patients with intraventricular hemorrhage casting in our hospital were retrospectively analyzed and divided into 2 groups including 82 patients with extraventricular hematoma drainage(control group)and 60 patients with frontal keyhole hematoma clearance(experiment group);and the intraoperative blood loss,postoperative residual hematoma,length of hospital stay,catheterization time,GOS score at discharge and postoperative complications of 2 groups were compared.Results The intraoperative blood loss,postoperative residual hematoma,length of hospital stay and catheterization time of experiment group were significantly less than control group(P<0.05).The GOS score at discharge of experiment group were significantly higher than control group(P<0.05).The postoperative mortality and hydrocephalus incidence of experiment group were significantly less than control group(P<0.05).There was no significant difference in the incidence of rebleeding,cerebral infarction and epilepsy after operation between 2 groups(P>0.05).Conclusion Compared with extraventricular hematoma drainage,frontal keyhole hematoma clearance in the treatment of patients with intraventricular hemorrhage casting can efficiently higher the effect of hematoma removal,improve the nerve function injury,accelerate the recovery process after operation and be helpful to reduce the risk of postoperative death and hydrocephalus.

关 键 词：手术 脑室出血 疗效 安全性 

分 类 号：R651.1[医药卫生—外科学]