抗血栓药物相关脑出血手术方式的选择分析  

作　　者：程中豪 陶开亮 李玉健 

机构地区：[1]杭州市中医院,310007

出　　处：《浙江临床医学》2024年第8期1195-1196,1199,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨不同手术方式治疗抗血栓药物相关脑出血的疗效。方法选择2017年1月至2022年1月抗血栓药物相关性脑出血患者52例,依据治疗方案的不同分为开颅手术组(33例)和立体定向组(19例)。比较两组患者手术时间,术后并发症,术后mRS评分等。结果开颅手术组:手术时间(197.91±56.17)min,术后发生颅内感染8例,癫痫10例,出现脑梗死灶5例,术后1个月mRS评分(4.67±0.96)分,术后死亡6例。立体定向组:手术时间(96.05±29.55)min,术后发生颅内感染2例,癫痫2例,出现脑梗死灶1例,术后1月mRS评分(3.52±1.39)分,术后死亡1例。两组手术时间,术后癫痫,术后1个月MRS差异统计学意义(P<0.05)。结论抗血栓药物相关脑出血的患者通常年龄较大,且大都合并有高血压,患者预后较差;选用立体定向手术的患者手术时间短,术后并发颅内感染等并发症少,术后短期预后优于开颅手术患者。Objective To explore the effect analysis of different surgical methods In cerebral hemorrhage associated with antithrombotic drugs Methods From January 2017 to January 2022,52 patients with cerebral hemorrhage associated with antithrombotic drugs admitted to our hospital were divided into the craniotomy group and the stereotactic group according to different treatment plans.Among them,there were 33 cases in the craniotomy group and 19 cases in the stereotactic group.The operation time,postoperative complications and postoperative mRS Scores of the two groups were observed and compared.Results In the craniotomy group,the average operation time was 197.91±56.17 minutes,8 cases of intracranial infection,10 cases of epilepsy,5 cases of infarction.The average MRS Score one month after surgery was 4.67±0.96,and 6 cases of postoperative death.In the stereotactic group,the average operation time was 96.05±29.55 minutes,2 cases of intracranial infection,2 cases of epilepsy,1 case of infarction,the average MRS Score of 1 month after surgery was 3.52±1.39,and 1 case of death after surgery.Among them,the operation time,postoperative epilepsy and MRS of 1 month after operation were statistically significant(P<0.05).Conclusion For cerebral hemorrhage caused by antithrombotic drugs,the patients with antithrombotic drug-related cerebral hemorrhage are usually older,and most of them have hypertension,and the prognosis of patients is usually poor.However,the patients who choose stereotactic surgery have less operation time,less complications such as intracranial infection after surgery,and the short-term prognosis after surgery is better than that of patients with craniotomy.

关 键 词：抗血栓药物相关脑出血 立体定向 短期预后 

分 类 号：R651.1[医药卫生—外科学]