微创术治疗高血压脑出血的临床研究  

CLINCAL STUDY OF HYPERTENSIVE INTRACEREBRAL HEMORRHAGE TREATED BY MINIMALLY INVASIVE SURGERY

作　　者：黄波[1] 陈冬妹[2] 高添喜[1] 伍爱平[1] 刘勇[2] 雷飞跃 张雪平 何民 雷继敏[2] 

机构地区：[1]广东中山市博爱医院神经外科,中山528400 [2]广东省中山市博爱医院内科 [3]湖南郴州市医院神经外科

出　　处：《中国现代医学杂志》2003年第4期53-55,65,共4页China Journal of Modern Medicine

摘　　要：目的 :探讨微创颅内血肿清除术在高血压脑出血治疗中的优越性。方法 :保守组 38例行内科综合治疗 ,开颅组 38例在保守组治疗的基础上开骨瓣或骨窗 ,清除血肿 ,微创组 36例在保守组治疗的基础上行CT片定位法微创颅内血肿清除术 ,比较三组治疗的有效率、死亡率和治疗前、后神经功能缺损评分 ,采用t和 χ2 检验比较。结果 :保守组有效率 4 2 .1% ,死亡率 2 1.1% ,开颅组有效率为 5 5 .3% ,死亡率为 10 .5 % ,微创组有效率为 91.7% ,死亡率 2 .8% ,微创组与开颅组和保守组比较均有显著性差异 (P <0 .0 5 ) ;微创组于治疗后第 1天神经功能缺损评分即见明显减少 ,而开颅组和保守组均于治疗后第 14天才有明显减少 ,微创组与开颅组和保守组比较均有显著性差异 (P <0 .0 5 )。结论 :微创颅内血肿清除术在高血压脑出血治疗中能提高有效率、降低死亡率、加快神经功能恢复。Objective:To evaluate the advantages of minimally invasive evacuation of hematoma for treatment of hypertensive intracerebral hemorrhage. Methods:Thirty-eight cases in group A received conservative medical treatment, 38 cases in group B received craniotomy based on medical treatment and 36 cases in group C received minimally invasive evacuation based on medical treatment. The effective rate,mortality and neurological deficit scale of three groups were compared, and statistical data were processed with chi-square test.Results:The effective rate and mortality in group C were 91.7% and 2.8%, respectively, which was significantly different from that in group A(42.1% and 21.1%,respectively, P <0.05) and group B(55.3% and 10.5%,respectively, P <0.05). Conclusion:The minimally invasive evacuation of hematoma can improve the effective rate, decrease the mortality and promote the recovery of neurological function in the treatment of hypertensive intracerebral hemorrhage.

关 键 词：CT片定位法 微创术 开颅术 内科综合治疗 高血压脑出血 

分 类 号：R587.2[医药卫生—内分泌] R743.34[医药卫生—内科学]