YL-1型硬通道钻孔引流术结合立体定向治疗高血压脑出血的预后因素分析  

Prognostic factors analysis of YL-1 type hard channel trepanation and drainage combined with stereotactic therapy for hypertensive intracerebral hemorrhage

作　　者：刘彬 丁磊 成维鹏 范鹏坤 汪岩 张兵 任超 马修尧 LIU Bin;DING Lei;CHENG Weipeng;FAN Pengkun;WANG Yan;ZHANG Bing;REN Chao;MA Xiuyao(Cerebrovascular Disease Diagnosis and Treatment Center,the First People’s Hospital of Suzhou City,Suzhou,Anhui Province 234000 China)

机构地区：[1]安徽省宿州市第一人民医院脑血管病诊疗中心,234000

出　　处：《临床外科杂志》2024年第11期1142-1146,共5页Journal of Clinical Surgery

摘　　要：目的探究YL-1型硬通道钻孔引流术结合立体定向治疗高血压脑出血的临床疗效及预后影响因素。方法2019年8月~2022年10月收治的高血压脑出血病人110例,采用随机法分成两组,观察组55例,采用YL-1型硬通道钻孔引流术结合立体定向治疗;对照组55例,采用单纯YL-1型硬通道钻孔引流术。比较两组病人的围术期指标、神经受损情况以及预后情况;采用多因素Logistic回归分析病人预后影响因素。结果观察组的围术期指标、神经受损情况以及预后情况皆优于对照组(P<0.05);入院NIHSS评分(OR=2.504,P<0.05),手术方式为单纯微创钻孔引流(OR=1.881,P<0.05)、病程>24小时(OR=2.782,P<0.001)以及破入脑室(OR=2.252,P<0.05)是病人预后不良的危险因素。结论病人病程的延长、脑室破裂和严重的神经功能受损与预后不良相关,结合立体定向的微创术治疗对于脑出血病人预后的改善具有积极的意义。Objective To explore the clinical efficacy and prognostic factors of YL-1 type hard channel trepanation and drainage combined with stereotactic treatment for hypertensive intracerebral hemorrhage.Methods A retrospective study was conducted on 110 patients with hypertensive intracerebral hemorrhage at the Cerebrovascular Disease Center of the First People’s Hospital of Suzhou from August 2019 to October 2022.The observation group(55 cases)received YL-1 type hard channel drilling and drainage combined with stereotactic treatment,while the control group(55 cases)received simple YL-1 type hard channel drilling and drainage.The perioperative indicators,neurological damage,and prognosis of the two groups of patients were compared;Using multiple Logistic regression analysis to identify the prognostic factors affecting patients.Results The perioperative indicators,neurological damage,and prognosis of the observation group were better than those of the control group(P<0.05);The admission NIHSS score(OR=2.504,P<0.05),simple minimally invasive drilling and drainage(OR=1.881,P<0.05),disease duration>24 hours(OR=2.782,P<0.001),and ventricular rupture(OR=2.252,P<0.05)are risk factors for poor prognosis in patients.Conclusion The prolongation of the patient’s disease course,ventricular rupture,and severe neurological damage are associated with poor prognosis.Combining stereotactic minimally invasive surgery has a positive significance for improving the prognosis of patients with cerebral hemorrhage.

关 键 词：立体定向 高血压 脑出血 预后因素 YL-1型硬通道 钻孔引流术 

分 类 号：R651.1[医药卫生—外科学]