早期分步控制性减压手术治疗重症高血压脑出血的有效性探讨  

Effectiveness of Early Step-by-step Controlled Decompression Surgery in the Treatment of Severe Hypertensive Intracerebral Hemorrhage

作　　者：王涛 WANG Tao(Department of Neurosurgery,Liaocheng Third People's Hospital,Liaocheng 252000,Shandong,China)

机构地区：[1]聊城市第三人民医院神经外科,山东聊城252000

出　　处：《系统医学》2024年第12期21-24,共4页Systems Medicine

摘　　要：目的 探究应用早期分步控制性减压手术治疗重症高血压脑出血患者的有效性。方法 非随机选取聊城市第三人民医院于2021年7月—2023年7月收治的重症高血压脑出血患者82例为研究对象,按不同的手术方式分成两组,各41例。对照组接受常规开颅血肿清除术治疗,观察组接受早期分步控制性减压手术治疗。对比两组治疗有效率、脑水肿体积、脑组织损伤相关指标、去骨瓣减压以及并发症发生率。结果 观察组总有效率(92.68%)高于对照组(75.61%),差异有统计学意义(χ^(2)=4.479,P<0.05)。观察组术后脑水肿体积小于对照组,脑组织损伤相关指标低于对照组,差异有统计学意义(P均<0.05)。两组去骨瓣减压发生率以及并发症发生率对比,差异无统计学意义(P均>0.05)。结论 采用早期分步控制性减压手术治疗重症高血压脑出血患者,有助于提高疗效,减轻脑水肿、脑损伤,安全性较高。Objective To explore the effectiveness of early step-by-step controlled decompression surgery in the treatment of severe hypertensive cerebral hemorrhage.Methods A total of eighty-two patients with severe hypertensive intracerebral hemorrhage admitted to Liaocheng Third People's Hospital from July 2021 to July 2023 were nonrandomly selected as the study objects,and were divided into two groups with forty-one cases each by different surgical methods.The control group received routine craniotomy hematoma removal,and the observation group received early step-by-step controlled decompression surgery.The effective rate of treatment,cerebral edema volume,brain tissue injury related indexes,decompressive craniectomy and complication rate were compared between the two groups.Results The total effective rate of the observation group(92.68%) was higher than that of the control group(75.61%),and the difference was statistically significant(χ^(2)=4.479,P<0.05).The postoperative cerebral edema volume of the observation group was lower than that of the control group,and the related indexes of brain tissue injury were lower than those of the control group,the difference was statistically significant(all P<0.05).There was no statistically significant difference in the incidence of decompressive craniotomy and the incidence of complications between the two groups(both P>0.05).Conclusion Early step-by-step controlled decompression surgery in the treatment of severe hypertensive cerebral hemorrhage is helpful to improve the curative effect,reduce brain edema and brain injury,and has high safety.

关 键 词：分期分步控制性减压手术 重症高血压脑出血 治疗效果 脑水肿体积 

分 类 号：R651.1[医药卫生—外科学]