脑内血肿清除术联合去大骨瓣减压术治疗高血压脑出血并脑疝患者的疗效分析  

Effect analysis of intracerebral hematoma removal combined with decompressive craniectomy in the treatment of hypertensive intracerebral hemorrhage complicated with cerebral hernia

作　　者：张重军 ZHANG Chong-jun(Bobai County People's Hospital,Yulin 537600,China)

机构地区：[1]博白县人民医院,537600

出　　处：《中国实用医药》2024年第5期46-49,共4页China Practical Medicine

摘　　要：目的 探析脑内血肿清除术联合去大骨瓣减压术在高血压脑出血并脑疝患者治疗中的应用效果。方法 135例高血压脑出血并脑疝患者,随机分为对照组(67例)与观察组(68例)。对照组采用脑内血肿清除术治疗,观察组患者采用脑内血肿清除术联合去大骨瓣减压术治疗。对比两组治疗效果,不同时间美国国立卫生研究院卒中量表(NIHSS)评分和Barthel指数,手术相关指标和住院时间,术后并发症发生情况,生活质量评分。结果 观察组治疗总有效率94.12%比对照组的80.60%高(P<0.05)。术后1周,观察组NIHSS评分(10.24±2.97)分低于对照组的(16.68±3.69)分, Barthel指数(75.98±5.73)分高于对照组的(70.25±7.16)分(P<0.05)。观察组手术时间(125.62±10.89)min、术中脑组织获得减压时间(42.62±5.62)min、住院时间(21.29±2.68)d比对照组的(52.34±4.81)min、(14.63±4.71)min、(18.65±2.23)d长,血肿清除率(79.84±8.56)%比对照组的(51.34±4.98)%高(P<0.05)。观察组术后并发症发生率4.41%比对照组的14.93%低(P<0.05)。观察组生理功能、心理状态、生活环境及社会能力评分比对照组高(P<0.05)。结论 脑内血肿清除术联合去大骨瓣减压术治疗高血压脑出血并脑疝患者效果显著,能够改善患者神经功能、生活质量、日常生活能力,降低并发症发生率,值得临床推广应用。Objective To explore the application effect of intracerebral hematoma removal combined with decompressive craniectomy in the treatment of hypertensive intracerebral hemorrhage complicated with cerebral hernia.Methods 135 patients with hypertensive cerebral hemorrhage and cerebral hernia were randomly divided into a control group(67 cases)and an observation group(68 cases).The control group was treated with intracerebral hematoma removal,and the observation group was treated with intracerebral hematoma removal and decompressive craniectomy.Both groups were compared in terms of treatment effect,National Institutes of Health Stroke Scale(NIHSS)score and Barthel index at different time points,surgery-related indicators and length of hospital stay,postoperative complications,and quality of life score.Results The total effective rate of 94.12%in the observation group was higher than 80.60%in the control group(P<0.05).1 week after surgery,NIHSS score of(10.24±2.97)points in the observation group was lower than(16.68±3.69)points in the control group,and Barthel index of(75.98±5.73)point was higher than(70.25±7.16)points in the control group(P<0.05).In the observation group,the operative time was(125.62±10.89)min,the intraoperative decompression time of brain tissue was(42.62±5.62)min and the length of hospital stay was(21.29±2.68)d,which were longer than(52.34±4.81)min,(14.63±4.71)min and(18.65±2.23)d in the control group;the observation group had higher hematoma clearance rate of(79.84±8.56)%than(51.34±4.98)%in the control group(P<0.05).The incidence of postoperative complications in the observation group was 4.41%,which was lower than 14.93%in the control group(P<0.05).The scores of physiological function,mental state,living environment and social ability of the observation group were higher than those of the control group(P<0.05).Conclusion Intracerebral hematoma removal combined with decompressive craniectomy has significant effects in the treatment of patients with hypertensive intracerebral hemorrhage a

关 键 词：高血压脑出血 脑疝 去大骨瓣减压术 脑内血肿清除术 

分 类 号：R651.12[医药卫生—外科学]